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As filed with the Securities and Exchange Commission on August 15, 2014

Registration No. 333-197383

 

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

Amendment No. 1 to

FORM S-1

REGISTRATION STATEMENT

UNDER

THE SECURITIES ACT OF 1933

 

 

AAC HOLDINGS, INC.

(Exact name of registrant as specified in its charter)

 

 

 

Nevada   8093   35-2496142

(State or other jurisdiction of

incorporation or organization)

 

(Primary Standard Industrial

Classification Code Number)

 

(I.R.S. Employer

Identification No.)

115 East Park Drive, Second Floor

Brentwood, TN 37027

(615) 732-1231

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive office)

 

 

Michael T. Cartwright

Chief Executive Officer and Chairman of the Board

AAC Holdings, Inc.

115 East Park Drive, Second Floor

Brentwood, TN 37027

(615) 732-1231

(Name, address, including zip code, and telephone number, including area code, of agent for service)

 

 

Copies to:

 

Howard H. Lamar III, Esq.

Laura R. Brothers, Esq.

Bass, Berry & Sims PLC

150 3 rd Avenue S., Suite 2800

Nashville, TN 37201

(615) 742-6200

 

Michael P. Heinz, Esq.

Lindsey A. Smith, Esq.

Sidley Austin LLP

One South Dearborn

Chicago, IL 60603

(312) 853-7000

 

 

Approximate date of commencement of proposed sale to the public : As soon as practicable after the effective date of this registration statement.

If any of the securities being registered on this Form are to be offered on a delayed or continuous basis pursuant to Rule 415 under the Securities Act of 1933, check the following box.   ¨

If this Form is filed to register additional securities for an offering pursuant to Rule 462(b) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering.   ¨

If this Form is a post-effective amendment filed pursuant to Rule 462(c) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering.   ¨

If this Form is a post-effective amendment filed pursuant to Rule 462(d) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering.   ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (check one)

 

Large Accelerated filer   ¨    Accelerated filer   ¨
Non-accelerated filer   x   (Do not check if a smaller reporting company)    Smaller reporting company   ¨

The Registrant hereby amends this Registration Statement on such date or dates as may be necessary to delay its effective date until the Registrant shall file a further amendment which specifically states that this Registration Statement shall thereafter become effective in accordance with Section 8(a) of the Securities Act of 1933, as amended, or until the Registration Statement shall become effective on such date as the Securities and Exchange Commission, acting pursuant to Section 8(a), may determine.

 

 

 


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LOGO

The information in this preliminary prospectus is not complete and may be changed. We may not sell these securities until the registration statement filed with the Securities and Exchange Commission is effective. This preliminary prospectus is not an offer to sell these securities and is not soliciting an offer to buy these securities in any jurisdiction where the offer or sale is not permitted.
SUBJECT TO COMPLETION, DATED AUGUST 15, 2014
PRELIMINARY PROSPECTUS
Shares
Amercian Addiction Centers
AAC Holdings, Inc.
Common Stock
This is the initial public offering of our common stock, and no public market currently exists for our stock. We currently expect the initial public offering price to be between $         and $         per share of common stock.
We have granted the underwriters a 30-day option to purchase up to              additional shares of common stock to cover over-allotments, if any.
Our common stock has been approved for listing on the New York Stock Exchange under the symbol “AAC”.
We are an “emerging growth company” under the federal securities laws and will be subject to reduced public company reporting requirements. Investing in our common stock involves risks. See “Risk Factors” beginning on page 15.
Per Share
Total
Initial public offering price
  $            
  $            
Underwriting discounts and commissions1
  $            
  $            
Proceeds, before expenses, to us
  $            
  $            
1 We refer you to “Underwriting” beginning on page 138 for additional information regarding underwriting compensation.
Neither the Securities and Exchange Commission nor any state securities commission has approved or disapproved of these securities or determined if this prospectus is truthful or complete. Any representation to the contrary is a criminal offense.
The underwriters expect to deliver the shares on or about                     , 2014 through the book-entry facilities of The Depository Trust Company.
Joint Book-Running Managers
William Blair
Wells Fargo Securities
Raymond James
Avondale Partners
The date of this prospectus is                     , 2014


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LOGO

Our research-based treatment methods and clinical practices have helped thousands treat their addictions. Greenhouse Dallas, Texas


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LOGO

American Addiction Centers’ treatment philosophy binds together decades of findings and practices into the essential elements that are designed to help anyone beat addiction.
Greenhouse Dallas, Texas


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LOGO

 


Table of Contents

TABLE OF CONTENTS

 

     Page  

Summary

     1   

Risk Factors

     15   

Special Note Regarding Forward-Looking Statements

     34   

Use of Proceeds

     36   

Dividend Policy

     37   

Capitalization

     38   

Dilution

     39   

Unaudited Pro Forma Consolidated Financial Statements

     41   

Selected Historical and Pro Forma Consolidated Financial and Operating Data

     49   

Management’s Discussion and Analysis of Financial Condition and Results of Operations

     54   

Business

     84   

Management

     105   

Executive Compensation

     113   

Certain Relationships and Related Party Transactions

     120   

Principal Stockholders

     127   

Description of Capital Stock

     129   

Shares Eligible For Future Sale

     132   

Material U.S. Federal Income Tax Consequences to Non-U.S. Holders

     134   

Underwriting (Conflict of Interest)

     138   

Validity of the Common Stock

     144   

Experts

     144   

Where You Can Find More Information

     144   

Index to Financial Statements

     F-1   

You should rely only on the information contained in this prospectus to which we have referred you. No dealer, salesperson or other person is authorized to give any information or to represent anything not contained in this prospectus. You must not rely on any unauthorized information or representations. This prospectus is an offer to sell only the shares of common stock offered hereby, but only under circumstances and in jurisdictions where it is lawful to do so. The information contained in this prospectus is accurate only as of the date of this prospectus or as of another date specified herein.

Trademarks, Trade Names and Service Marks

This prospectus includes our trademarks such as “American Addiction Centers,” “Desert Hope,” “FitRx,” “Forterus,” “Greenhouse,” “Singer Island,” “The Academy” and other company trade names and service marks that are protected under applicable intellectual property laws and constitute the property of AAC Holdings, Inc. or its subsidiaries. For convenience, we may not include the ® or ™ symbols, but such failure is not meant to indicate that we would not protect our intellectual property rights to the fullest extent allowed by law. Any other trademarks, trade names or service marks referred to in this registration statement are the property of their respective owners.

Industry and Market Data

Market data and other statistical information contained in this registration statement are based on independent industry publications, government publications, reports by market research firms and other published independent sources and reports. Some data is also based on our good faith estimates, which are derived from other relevant statistical information. Statements as to our market position are based on market data currently available to us and, primarily, on management estimates, as information regarding most of our major competitors is not publicly available. Our estimates involve risks and uncertainties and are subject to change based on various factors, including those discussed under the heading “Risk Factors” in this prospectus.


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PROSPECTUS SUMMARY

This summary highlights the information contained elsewhere in this prospectus. Because it is only a summary, it does not contain all of the information that may be important to you. Before investing in our common stock, you should read this entire prospectus, including the information set forth under the heading “Risk Factors” and the financial statements and the notes thereto. In this prospectus, unless we indicate otherwise or the context requires, “we,” “our,” “us” and the “company” refer, prior to the Reorganization Transactions discussed below, to American Addiction Centers, Inc. and, after the Reorganization Transactions, to AAC Holdings, Inc., in each case together with its consolidated subsidiaries. The term “Holdings” refers to AAC Holdings, Inc. and the term “AAC” refers to American Addiction Centers, Inc. Unless otherwise noted, all information in this prospectus assumes (i) no exercise of the underwriters’ over-allotment option and (ii) the consummation of the Reorganization Transactions described under the caption “Reorganization Transactions.”

Our Business

We believe we are a leading provider of inpatient substance abuse treatment services for individuals with drug and alcohol addiction. As of July 31, 2014, we operated six substance abuse treatment facilities located throughout the United States, focused on delivering effective clinical care and treatment solutions across our 467 beds, which included 338 licensed detoxification beds. In addition, we have three facilities under development and an additional property under contract that we plan to develop into a new facility. The majority of our 715 employees are highly trained clinical staff who deploy research-based treatment programs with structured curricula for detoxification, residential treatment, partial hospitalization and intensive outpatient care. By applying a tailored treatment program based on the individual needs of each client, many of whom require treatment for a co-occurring mental health disorder, such as depression, bipolar disorder and schizophrenia, we believe we offer the level of quality care and service necessary for our clients to achieve and maintain sobriety. For the years ended December 31, 2013 and December 31, 2012, we had $115.7 million and $66.0 million in revenues, $11.6 million and $7.2 million in Adjusted EBITDA and $1.5 million and $1.1 million in net income, respectively. See “Summary Historical and Pro Forma Consolidated Financial and Operating Data” for a discussion of Adjusted EBITDA and a reconciliation of Adjusted EBITDA to net income, the most directly comparable GAAP measure.

We have made substantial investments in our treatment facilities with a specific focus on providing aesthetically pleasing properties and grounds, numerous amenities, healthy food and a courteous and attentive staff to distinguish us from our competitors. Our commitment to clinical excellence, premium facilities and customer service has allowed us to form relationships across a broad set of key referral sources, including hospitals, other treatment facilities, employers, alumni and employee assistance programs. In 2013 and the six months ended June 30, 2014, approximately 90% of our revenues were reimbursable by commercial payors, including amounts paid by such payors to clients, and the remaining portion was payable directly by our clients. We currently do not receive any revenues from government healthcare payment programs such as Medicare and Medicaid. Our platform is supported by a centralized infrastructure that includes a multi-faceted sales and marketing program, call center operations, a laboratory facility, billing and collection services and support functions. This infrastructure, in conjunction with our premium service offerings, has enabled us to develop a strong national brand. The substantial investments we have made at a corporate level contribute to our operational efficiencies and provide us flexibility to place clients at a variety of our facilities in order to optimize care that best fits both the clients’ clinical needs and their insurance benefits.

 

 

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Our Industry

Addiction is a chronic disease that affects brain function and behavior. Substance abuse, specifically the abuse of drugs and alcohol, is one of the most common and serious forms of addiction. If left untreated, substance abuse can lead to a variety of destructive social conditions such as problems at home or work, violence, crime and even death. According to the National Institute on Drug Abuse, or NIDA, the total societal cost of substance abuse in the United States is estimated to be over $600 billion annually. The 2012 National Survey on Drug Use and Health estimates that approximately 23.1 million people aged 12 or older needed treatment for a drug or alcohol use problem in the United States in 2012, of which only 2.5 million, or 10.8% of those needing treatment, received treatment at a specialty facility. The mental health and substance abuse treatment industry is expected to continue to expand as a result of a combination of factors, including increased awareness and de-stigmatization of substance abuse treatment and recent healthcare reform improving access to care, particularly for young adults now able to access their parents’ insurance. According to a 2008 report by the Substance Abuse and Mental Health Services Administration, or SAMHSA, annual spending on treatment for substance abuse in the United States is expected to grow to $35 billion in 2014.

The National Comorbidity Survey reports that up to 65% of adults with substance abuse addiction also have a co-occurring mental health disorder, defined by SAMHSA as at least one major mental health disorder, such as depression, bipolar disorder and schizophrenia, occurring concurrently with substance abuse. According to the Disease Management and Health Outcomes Journal, integrating treatment for both substance abuse and a co-occurring mental health disorder is believed to result in significantly better outcomes.

In addition to strong industry growth dynamics, the substance abuse treatment sector has several favorable attributes that differentiate it from other healthcare services sectors. Of particular note, as a result of the nature of substance abuse treatment, clients have more control in deciding when to seek treatment and who to select as their treatment provider. Also, clients are typically not limited to their local geographic area in selecting a treatment facility. As a result, providers are able to market and advertise directly to potential clients and their families on a national level.

Our Competitive Strengths

We believe the following strengths differentiate us from our competitors and will allow us to successfully operate and grow our business:

 

    Leading substance abuse treatment platform. We believe we are a leading provider of substance abuse treatment services based on the scale and nationwide reach of our platform, quality of our facilities and breadth of our treatment capabilities. We believe we offer one of the largest for-profit fully licensed programs to treat drug and alcohol addiction regardless of stage or severity. In addition, we believe our commitment to quality and customer service, as well as our dedication to clinical excellence, results in improved client retention, an important factor in ensuring clients receive the care they need.

 

    Comprehensive addiction treatment programs with co-occurring mental health disorder treatment capabilities. Our clinical staff is trained to deploy a research-based treatment program with a structured curriculum, particularly focused on identifying and addressing the needs of clients with co-occurring mental health disorders. Given that up to 65% of adults with substance abuse addiction are estimated to also have at least one co-occurring mental health disorder, we believe our medical and clinical staff’s ability to identify and treat both disorders is critical in helping clients achieve sobriety. We believe our ability to address these complex conditions enhances our reputation with clients, their families and other referral sources.

 

 

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    Proven ability to develop de novo treatment facilities. We have a successful track record of identifying suitable de novo sites, securing properties, overseeing the licensing and development of facilities and integrating de novo centers into our broader platform. We have successfully transformed acquired properties, such as a luxury spa and an assisted living facility, into substance abuse treatment facilities. We believe our skill and experience in executing our de novo development strategy provides us with a competitive advantage in quickly and cost-effectively developing substance abuse treatment facilities and enrolling clients.

 

    Multi-faceted sales and marketing program. Our national sales and marketing program provides a competitive advantage compared to treatment facilities that primarily target local geographic areas and use fewer marketing channels to attract clients. Our national team of 36 professional sales representatives develops and maintains relationships with key referral sources such as hospitals, other treatment facilities, employers, alumni and employee assistance programs. In addition, our team of over 60 centralized, trained call center treatment consultants provides coverage and support 24 hours a day, seven days a week. Our coordinated approach across multiple channels and our ability to serve clients from our varied facilities across the United States allows us to reach a broad audience of potential clients and build a nationally recognized brand.

 

    Attractive payor mix and diversified client base . We have generated revenues solely from commercial payors and our clients with no reimbursement from government healthcare payment programs such as Medicare and Medicaid, which are typically subject to lower reimbursement rates. The relationships we have developed with our referral sources enhance our interactions with payors and help us achieve our attractive reimbursement profile. For the year ended December 31, 2013 and the six months ended June 30, 2014, approximately 90% of our revenues were reimbursable by commercial payors, including amounts paid by such payors to clients, with the remaining portion of our revenues payable directly by our clients. No single payor in 2013 or the first half of 2014 accounted for more than 12.3% and 14.5% of our revenue reimbursements, respectively.

 

    Strong financial performance and attractive returns on invested capital . We have achieved strong financial performance in terms of recent growth and profitability. Our revenues for the year ended December 31, 2013 were $115.7 million, representing a 75.3% increase over $66.0 million in 2012. We have demonstrated the ability to generate attractive returns on investment with our de novo development strategy. Each of our two de novo developments, Greenhouse and Desert Hope, which added 218 total beds on a combined basis, was profitable within its first year of operation.

 

    Experienced management team with track record of success . Our senior management team, with an average of over 15 years of experience in the healthcare industry, has significant experience developing, operating and growing a variety of behavioral health treatment facilities. We believe the combination of our management team’s skills and experiences provides us with an advantage in developing high quality de novo treatment facilities and quickly integrating them into our broader platform.

Our Growth Strategy

We have developed our company and the American Addiction Centers national brand through substantial investment in our facilities, our clinical expertise, our professional staff and our national sales and marketing program. We seek to extend our position as a leading provider of treatment for drug and alcohol addiction by executing the following growth strategies:

 

    Improve census at existing facilities by increasing our client leads through our multi-faceted sales and marketing program.

 

 

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    Expand capacity at existing residential facilities by selectively increasing our number of residential beds, expanding our clinical facility space and hiring additional clinical staff to enable us to provide services to additional clients. In July 2014, we completed the expansion of our Greenhouse facility to add 60 inpatient beds, all of which are licensed for detoxification.

 

    Pursue de novo development of residential facilities built on the success of two full-service residential treatment facilities that we developed in the past two years: Greenhouse, a former luxury spa in Dallas, Texas, and Desert Hope, a former assisted living facility in Las Vegas, Nevada.

 

    Opportunistically pursue treatment facility acquisitions to expand and diversify our geographic presence and service offerings.

 

    Expand outpatient operations to complement our broader network of residential treatment facilities and further enhance our brand and our ability to provide a more comprehensive suite of services across the spectrum of care.

 

    Target complementary growth opportunities, including providing pharmacy and laboratory services, expanding licensure of existing facilities, treating other mental health and wellness disorders and expanding other ancillary services.

Our Substance Abuse Treatment Facilities

The following table presents information, as of June 30, 2014, about our network of substance abuse treatment facilities, including current facilities, facilities under development and properties under contract:

 

Facility Name (1)

  

Location

   Capacity
(beds)
    First Clients
Served
 

Treatment
Certifications (2)

   Real Property
Leased /
Owned

Desert Hope

   Las Vegas, NV      148      2013   DTX, RTC, PHP, IOP    Owned

Greenhouse

  

Grand Prairie, TX

(Dallas area)

     130 (3)     2012   DTX, RTC, PHP, IOP    Owned

Forterus

   Temecula, CA      76      2004   DTX, RTC, PHP, IOP    Leased

Singer Island

   West Palm Beach, FL      65      2012   PHP, IOP    Leased

San Diego Addiction Treatment Center

   San Diego, CA      36      2010   DTX, RTC, PHP, IOP    Leased

The Academy

   West Palm Beach, FL      12      2012   PHP, IOP    Leased

TBD

  

Riverview, FL

(Tampa area)

     164 (4)     Under

Development (4)

  DTX, RTC, PHP, IOP (4)    Owned

TBD

  

Arlington, TX

(Dallas area)

     n/a      Under
Development (5)
  PHP, IOP (5)    Owned

TBD

   Las Vegas, NV      n/a      Under
Development (6)
  PHP, IOP (6)    Owned

TBD

   Ringwood, NJ (New York City area)      150 (7)     Under

Contract (7)

  DTX, RTC, PHP, IOP (7)    n/a

 

(1) Excluded from this table is our non-substance abuse treatment facility, FitRx, which is a 20-bed leased facility located in Brentwood, Tennessee that provides outpatient treatment services for men and women who struggle with obesity-related behavioral disorders.

(2) DTX: Detoxification; RTC: Residential Treatment; PHP: Partial Hospitalization; IOP: Intensive Outpatient.

(3) This figure includes 60 additional beds as a result of the Greenhouse expansion completed in July 2014, with respect to which we received licensure in July 2014.

(4) Reflects our current expectations with respect to this facility, on which we began construction in May 2014 and target opening in the second half of 2015.

 

 

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(5) In March 2014, we acquired an approximately 20,000 square foot property in Arlington, Texas. We began construction of an outpatient treatment facility at this location in July 2014, and we are targeting opening this facility in the first half of 2015. The facility will provide treatment services and additional programming space for our Greenhouse facility. Treatment certifications reflect our expectations.

(6) In May 2014, we acquired an approximately 20,000 square foot property in Las Vegas, Nevada. We began construction of an outpatient treatment facility at this location in July 2014, and we are targeting opening this facility by the end of 2014. The facility will provide treatment services and additional programming space for our Desert Hope facility. Treatment certifications reflect our expectations.

(7) We entered into a purchase agreement to acquire a 96 acre property located fewer than 50 miles from New York City, subject to the satisfaction of certain closing conditions and the arrangement of financing. We anticipate beginning construction of a residential treatment facility at this location by early 2015, and we are targeting opening this facility in 2016 with approximately 150 beds. Treatment certifications reflect our expectations.

Risks Related to Our Business

Our business is subject to a number of risks that you should understand before making an investment decision. These risks, which are discussed more fully in “Risk Factors” following this prospectus summary, include the following:

 

    We currently operate a limited number of treatment facilities. Our revenues, profitability and cash flows could be materially adversely affected if we are unable to operate certain key treatment facilities, our corporate office or our laboratory facility.

 

    We rely on our multi-faceted sales and marketing program to continuously attract and enroll clients to our network of facilities. Any disruption in our national sales and marketing program would have a material adverse effect on our business, financial condition and results of operations.

 

    We derive a significant portion of our revenues from providing services to clients covered by third-party payors who could reduce their reimbursement rates or otherwise restrain our ability to obtain, or provide services to, clients. This risk is heightened because we are generally an “out-of-network” provider.

 

    An increase in uninsured and underinsured clients or the deterioration in the collectability of the accounts of such clients could have a material adverse effect on our business, financial condition and results of operations.

 

    If we overestimate the reimbursement amounts that payors will pay us for services performed, it would increase our revenue adjustments, which could have a material adverse effect on our revenues, profitability and cash flows and lead to significant shifts in our results of operations from quarter to quarter that may make it difficult to project long-term performance.

 

    We will need additional financing to execute our business plan and fund operations, which additional financing may not be available on reasonable terms or at all.

 

    Our business may face significant risks with respect to future de novo expansion, including the time and costs of identifying new geographic markets, the ability to obtain necessary licensure and other zoning or regulatory approvals and significant start-up costs including advertising, marketing and the costs of providing equipment, furnishings, supplies and other capital resources.

 

    Our acquisition strategy exposes us to a variety of operational and financial risks, which may have a material adverse effect on our business, financial condition and results of operations.

 

    Our ability to maintain census and, to a lesser extent, the average length of stay of our clients is dependent on a number of factors outside of our control, and if we are unable to maintain census, or if we experience a significant decrease in average length of stay, our business, results of operations and cash flows could be materially adversely affected.

 

 

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    If we fail to comply with the extensive laws and government regulations impacting our industry, we could suffer penalties, be the subject of federal and state investigations and potential claims and legal actions by clients, employees and others or be required to make significant changes to our operations, which may reduce our revenues, increase our costs and have a material adverse effect on our business, financial condition and results of operations.

 

    Our directors, executive officers and principal stockholders and their respective affiliates will continue to have substantial control over the company after this offering and could delay or prevent a change in corporate control.

Emerging Growth Company

We are an “emerging growth company,” as defined in the Jumpstart Our Business Startups Act of 2012, or the JOBS Act. We will remain an emerging growth company until the earlier of (1) the last day of the fiscal year (a) following the fifth anniversary of the completion of this offering, (b) in which we have total annual gross revenues of at least $1.0 billion, or (c) in which we are deemed to be a large accelerated filer, which means the market value of our common stock that is held by non-affiliates was $700.0 million or more as of the prior June 30th, and (2) the date on which we have issued more than $1.0 billion in non-convertible debt during the prior three-year period.

As an emerging growth company, we may take advantage of specified reduced disclosure and other requirements that may otherwise be applicable to public companies. These provisions include:

 

    only two years of audited consolidated financial statements in addition to any required unaudited interim financial statements with correspondingly reduced “Management’s Discussion and Analysis of Financial Condition and Results of Operations” disclosure;

 

    reduced disclosure about our executive compensation arrangements;

 

    no requirement that we hold non-binding advisory votes on executive compensation or golden parachute arrangements; and

 

    exemption from the auditor attestation requirement in the assessment of our internal control over financial reporting.

We have taken advantage of some of these reduced requirements and may continue to do so for so long as we remain an emerging growth company, and thus the information we provide stockholders may be less than what you might receive from other public companies in which you hold shares.

Reorganization Transactions

AAC Holdings, Inc. was incorporated as a Nevada corporation on February 12, 2014 for the purpose of acquiring all of the common stock of American Addiction Centers, Inc. and to engage in certain reorganization transactions, as described below. In April 2014, Holdings completed the following transactions:

 

    a voluntary private share exchange with certain stockholders of AAC, whereby holders representing 93.6% of the outstanding shares of common stock of AAC exchanged their shares on a one-for-one basis for shares of Holdings common stock, which we refer to as the Private Share Exchange;

 

   

substantially concurrent with the Private Share Exchange, the acquisition of all of the outstanding common membership interests of Behavioral Healthcare Realty, LLC, or BHR, an entity controlled by related parties, which owns all the outstanding equity interests of Concorde Real Estate, LLC, Greenhouse Real Estate, LLC and The Academy Real Estate, LLC, which entities own the Desert Hope,

 

 

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Greenhouse and Riverview, Florida properties, respectively, in exchange for $3.0 million in cash, the assumption of a $1.8 million term loan and 521,999 shares of Holdings common stock, representing 5.2% of our outstanding common stock immediately prior to this offering, which we refer to as the BHR Acquisition; and

 

    substantially concurrent with the Private Share Exchange and BHR Acquisition, the acquisition of all of the outstanding membership interests of Clinical Revenue Management Services, LLC, or CRMS, an entity controlled by related parties, which provides client billing and collection services for AAC, in exchange for $0.5 million in cash and 149,144 shares of Holdings common stock, representing 1.5% of our outstanding common stock immediately prior to this offering, which we refer to as the CRMS Acquisition.

As a result of the foregoing transactions, which are collectively referred to as the “Reorganization Transactions,” Holdings now owns (i) 93.6% of the outstanding common stock of AAC, (ii) 100% of the outstanding common membership interests in BHR, which represents 100% of the voting rights in BHR, and (iii) 100% of the outstanding membership interests in CRMS. To help fund or facilitate the Reorganization Transactions, the following additional financing transactions were undertaken in 2014 prior to or in connection with the Reorganization Transactions: (i) AAC sold 471,843 shares of its common stock in a private placement to certain accredited investors from February 2014 through April 2014, with net proceeds of $6.0 million, (ii) BHR sold 8.5 Series A Preferred Units in a private placement to certain accredited investors in January and February 2014 with net proceeds of $0.4 million, (iii) BHR redeemed all of the outstanding 36.5 Series A Preferred Units from certain accredited investors in April 2014 and (iv) BHR sold 160 new Series A Preferred Units in a private placement to an accredited investor in April 2014 with net proceeds of $7.8 million. For additional information related to the Reorganization Transactions, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and Note 3 to our unaudited condensed consolidated financial statements included elsewhere in this prospectus.

Subsequent to this offering, we expect to conduct a subsidiary short-form merger with AAC whereby the legacy holders who did not participate in the Private Share Exchange would be entitled to receive Holdings shares on a one-for-one basis. Upon the completion of the short-form merger, Holdings would own 100% of AAC. No assurance can be given that the subsequent short-form merger will occur in a timely manner or at all.

Corporate Information

AAC Holdings, Inc. is a Nevada corporation. Our principal executive offices are located at 115 East Park Drive, Second Floor, Brentwood, Tennessee 37027, and our telephone number is (615) 732-1231. Our website address is www.americanaddictioncenters.com . The information contained on, or that can be accessed through, our website is not a part of this prospectus. Investors should not rely on any such information in deciding whether to purchase our common stock. We have included our website address in this prospectus solely as an inactive textual reference.

 

 

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The Offering

 

Common stock offered by us

             shares

 

Common stock to be outstanding immediately after this offering

             shares

 

Option to purchase additional shares

We have granted the underwriters a 30-day option to purchase up to an additional              shares of our common stock to cover over-allotments, if any.

 

Use of proceeds

We estimate that the net proceeds to us from this offering, after deducting underwriting discounts and commissions and estimated offering expenses payable by us, will be approximately $         million assuming a public offering price of $         per share (the midpoint of the range set forth on the cover page of this prospectus). We intend to use the net proceeds to repay approximately $         million of outstanding indebtedness and the remaining approximately $         million of net proceeds for working capital and other general corporate purposes, which may include the financing of future potential acquisitions and de novo facility developments. See “Use of Proceeds.”

 

Dividend policy

We do not anticipate paying dividends on our common stock for the foreseeable future. See “Dividend Policy.”

 

Risk factors

For a discussion of certain factors you should consider before making an investment, see “Risk Factors.”

 

Conflict of interest

An affiliate of Wells Fargo Securities, LLC, an underwriter in this offering, is the lender under our amended and restated credit facility and will receive more than 5% of the net proceeds from this offering. Accordingly, Wells Fargo Securities, LLC will be deemed to have a “conflict of interest” with us within the meaning of Rule 5121 of the Conduct Rules of the Financial Industry Regulatory Authority, Inc., or FINRA. William Blair & Company, L.L.C. has agreed to serve as a “qualified independent underwriter” as defined by FINRA and performed due diligence investigations and reviewed and participated in the preparation of the registration statement of which this prospectus forms a part. See “Underwriting—Conflict of Interest.”

 

New York Stock Exchange symbol

“AAC”

 

Directed share program

At our request, the underwriters have reserved up to 5% of the common stock being offered by this prospectus for sale at the initial public offering price to our directors, officers and certain of our employees. See “Underwriting.”

 

 

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The number of shares of common stock to be outstanding immediately after this offering is based on the number of shares outstanding as of                     , 2014, plus the issuance of             shares of common stock in this offering and excludes (i) 1,000,000 shares of common stock reserved for future issuance under our 2014 Equity Incentive Plan, or the 2014 Plan, which we have adopted in connection with this offering, and (ii) 630,886 shares of common stock, which we plan to issue in connection with the subsidiary short-form merger with AAC subsequent to this offering.

Except as otherwise noted, all information in this prospectus:

 

    assumes no exercise of the underwriters’ over-allotment option; and

 

    gives effect to a             -for-1 stock split effected on                     , 2014.

 

 

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SUMMARY HISTORICAL AND PRO FORMA CONSOLIDATED FINANCIAL AND OPERATING DATA

The following tables present our summary historical and pro forma consolidated financial and operating data as of the dates and for the periods indicated. Holdings was formed as a Nevada corporation on February 12, 2014, and acquired 93.6% of the outstanding shares of common stock of AAC on April 15, 2014 in connection with the Reorganization Transactions, and Holdings therefore controls AAC. Prior to the completion of the Reorganization Transactions, Holdings had not engaged in any business or other activities except in connection with its formation. Accordingly, all financial and operating data herein relating to periods prior to the completion of the Reorganization Transactions is that of AAC and its consolidated subsidiaries and is referred to herein as “our” historical financial and operating data.

The summary consolidated financial data as of and for the years ended December 31, 2012 and 2013 are derived from our audited consolidated financial statements included elsewhere in this prospectus. The summary consolidated financial data for the year ended December 31, 2011 are derived from our audited consolidated financial statements not included in this prospectus. The summary consolidated financial data as of June 30, 2014 and for the six months ended June 30, 2013 and 2014 are derived from our unaudited condensed consolidated financial statements included elsewhere in this prospectus. The results for the six months ended June 30, 2013 and the six months ended June 30, 2014 are not necessarily indicative of the results that may be expected for the entire year. The following summary consolidated financial data should be read together with our audited consolidated financial statements, unaudited condensed consolidated financial statements and accompanying notes and information under the caption “Management’s Discussion and Analysis of Financial Condition and Results of Operations” included elsewhere in this prospectus.

The summary unaudited pro forma financial and other data for the year ended December 31, 2013 and as of and for the six months ended June 30, 2014 have been adjusted to give effect to this offering and our intended use of proceeds from this offering and, in the case of the unaudited pro forma consolidated income statement data, certain other transactions as described in the section titled “Unaudited Pro Forma Consolidated Financial Statements” included elsewhere in this prospectus. Specifically, the “Pro Forma as Adjusted” columns in the summary unaudited pro forma consolidated income statement and other data give effect to the Reorganization Transactions, the related financing transactions and this offering and our intended use of proceeds therefrom as described in “Use of Proceeds,” in each case for the year ended December 31, 2013 and for the six months ended June 30, 2014. This data is subject and gives effect to the assumptions and adjustments described in the notes accompanying the unaudited pro forma consolidated financial statements included elsewhere in this prospectus. The summary unaudited pro forma financial data is presented for informational purposes only and should not be considered indicative of actual results of operations that would have been achieved had the transactions and this offering been consummated on the dates indicated and does not purport to be indicative of financial condition data or results of operations as of any future date or for any future period.

The “Pro Forma as Adjusted” columns do not include the effects of the CRMS Acquisition prior to the April 15, 2014 acquisition date, as CRMS’s only revenue stream is payments from us, and CRMS no longer has revenues subsequent to the completion of the CRMS Acquisition. Accordingly, CRMS does not meet the definition of a business under Regulation S-X Rule 11-01(d), and this transaction is not permitted to be included in the unaudited pro forma consolidated financial statements included elsewhere in this prospectus. However, for the purposes of the following table we have included an additional column to reflect the pro forma effects of the CRMS Acquisition because it provides investors with information from which to analyze our financial results in a manner that is consistent with the way management reviews and analyzes our results of operations as a combined company following the consummation of the Reorganization Transactions and the related financing transactions. In addition, we believe the “Pro Forma as Adjusted including CRMS Acquisition” income statement data provide investors with the most meaningful comparison between our financial results for prior and future periods.

 

 

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                Year Ended
December 31, 2013
    Six
Months
Ended
June 30,
2013
Actual

(unaudited)
    Six Months Ended
June 30, 2014
 
                Actual     Pro Forma
as Adjusted
    Pro Forma
as Adjusted
including
CRMS

Acquisition (1)
      Actual
(unaudited)
    Pro Forma
as Adjusted
    Pro Forma
as Adjusted
including
CRMS

Acquisition (1)
 
                           
    Year Ended
December 31,
               
    2011     2012                
    (in thousands, except for share and per share amounts)  

Income Statement Data:

                 

Revenues

  $ 28,275      $ 66,035      $ 115,741      $                   $                   $ 59,331      $ 59,203      $                   $                
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating expenses:

                 

Salaries, wages and benefits

    9,171        25,680        46,856            21,732        24,124       

Advertising and marketing

    4,915        8,667        13,493            6,588        7,079       

Professional fees

    1,636        5,430        10,277            4,706        4,895       

Client related services

    5,791        8,389        7,986            3,567        5,211       

Other operating expenses

    2,448        6,384        11,615            6,213        5,551       

Rentals and leases

    1,196        3,614        4,634            2,772        940       

Provision for doubtful accounts

    1,063        3,344        10,950            4,820        6,288       

Litigation settlement (2)

                  2,588            2,500        240       

Restructuring (3)

                  806            551              

Depreciation and amortization

    195        1,288        3,003            1,399        2,228       
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total operating expenses

    26,415        62,796        112,208            54,848        56,556       
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income from operations

    1,860        3,239        3,533            4,483        2,647       

Interest expense

    337        980        1,390            784        705       

Other (income) expense, net

           12        36            (27     15       
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income before income tax expense

    1,523        2,247        2,107            3,726        1,927       

Income tax expense

    652        1,148        615            1,745        859       
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income

    871        1,099        1,492            1,981        1,068       

Less: net loss (income) attributable to noncontrolling interest (4)

           405        (706         (343     668       
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to AAC Holdings, Inc. stockholders

    871        1,504        786            1,638        1,736       

Deemed contribution—redemption of Series B Preferred Stock

                  1,000            1,000              

BHR Series A Preferred Unit dividend

                                    (203    
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income available to AAC Holdings, Inc. common stockholders

  $ 871      $ 1,504      $ 1,786      $        $        $ 2,638      $ 1,533      $        $     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Earnings per share attributable to common stockholders (5) :

                 

Basic

  $ 0.20      $ 0.19      $ 0.20      $        $        $ 0.30      $ 0.16      $        $     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Diluted

  $ 0.20      $ 0.19      $ 0.20      $        $        $ 0.30      $ 0.16      $        $     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Weighted-average shares outstanding:

                 

Basic

    4,287,131        7,770,359        8,819,062            8,671,942        9,510,427       

Diluted

    4,314,051        7,869,017        9,096,660            8,734,934        9,544,420       

Other Financial Information:

                 

Adjusted EBITDA (6)

  $ 2,055      $ 7,168      $ 11,558      $        $        $ 9,580      $ 7,832      $        $     

 

 

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     As of December 31,      As of June 30, 2014  
        Actual
(unaudited)
     Pro Forma
as
Adjusted (7)
 
         2012              2013            
     (in thousands)  
                             

Balance Sheet Data:

           

Cash and cash equivalents

   $ 740       $ 2,012       $ 2,382       $                

Working capital

     3,190         1,220         3,729      

Total assets

     53,598         81,638         93,752      

Total debt, including current portion

     25,222         43,075         46,794      

Total mezzanine equity (including noncontrolling interest) (8)

     11,613         11,842         7,835      

Total stockholders’ equity (including noncontrolling interest) (9)

     4,678         11,883         26,497      

 

     Year Ended
December 31,
     Six Months
Ended June 30,
 
     2012      2013      2013      2014  

Operating Metrics: (unaudited):

           

Average daily census (10)

     238         339         365         376   

Average daily revenue (11)

   $ 759       $ 935       $ 906       $ 872   

Average net daily revenue (12)

   $ 722       $ 847       $ 827       $ 779   

New admissions (13)

     2,934         4,053         2,174         2,177   

Bed count at end of period (14)

     338         431         420         427   

 

(1) CRMS’s only revenue stream is payments from us, and CRMS no longer has revenues upon completion of the CRMS Acquisition. Accordingly, CRMS does not meet the definition of a business under Regulation S-X Rule 11-01(d), and this transaction is not permitted to be included in the unaudited pro forma consolidated financial statements included elsewhere in this prospectus. The 2013 column includes the historical results of CRMS for the year ended December 31, 2013 that consist of revenues of $3.4 million, salaries, wages and benefits of $2.0 million, professional fees of $0.1 million, other operating expenses of $0.5 million, rentals and leases of $0.2 million and depreciation and amortization of $0.1 million. These historical financial results are as adjusted for (i) the elimination of CRMS’s revenues of $3.4 million and the elimination of the corresponding $3.4 million of professional fees we paid to CRMS, (ii) the reduction of $0.3 million in salary expense for an executive officer whose employment ended effective upon the consummation of the CRMS Acquisition and (iii) recording a tax provision of $0.3 million on the historical income of CRMS and the pro forma adjustments at a tax rate of 36.0%. The first half of 2014 column includes the historical financial results of CRMS from January 1, 2014 through the acquisition date of April 15, 2014 that consist of revenues of $2.2 million, salaries, wages and benefits of $1.5 million, professional fees of $43,000, other operating expenses of $0.1 million and rentals and leases of $0.1 million. These historical results are adjusted for (i) the elimination of CRMS’s revenues of $2.2 million and the elimination of the corresponding $2.2 million of professional fees we paid to CRMS and (ii) the reduction of $0.1 million in salary expense for an executive officer whose employment ended effective upon the consummation of the CRMS Acquisition.

(2) We recorded a $2.5 million reserve in the second quarter of 2013 in connection with a consolidated wage and hour class action claim. We made a payment of $2.6 million in the second quarter of 2014 to settle the matter. For additional discussion of this litigation settlement, see Note 16 to our audited financial statements included elsewhere in this prospectus.

(3) During the first half of 2013, management adopted restructuring plans to centralize our call centers and to close the Leading Edge facility. As a result, aggregate restructuring and exit charges of $0.8 million were recognized in 2013, of which $0.6 million was recognized in the six months ended June 30, 2013. We did not recognize any restructuring expenses during 2012 as expenses related to the corporate relocation were not significant.

(4) Represents the net income attributable to the stockholders of AAC that did not exchange their shares for Holdings common stock for the period from April 15, 2014 to June 30, 2014, the net income (loss) attributable to the noncontrolling interest in BHR (for 2012, 2013 and through the acquisition date of April 15, 2014) and the Professional Groups (as defined in “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Consolidation of VIEs”) (for 2013 and the six month period ended June 30, 2014) and the net income (loss) in the Pro Forma as Adjusted columns and the Pro Forma as Adjusted including CRMS Acquisition columns of the Professional Groups.

(5) After giving effect to the subsidiary short-form merger with AAC that we expect to complete subsequent to this offering, pro forma basic and diluted earnings per share attributable to common stockholders would be              and             , respectively, based on pro forma basic and diluted weighted-average shares outstanding of                      and                     , respectively.

(6) Adjusted EBITDA is a “non-GAAP financial measure” as defined under the rules and regulations promulgated by the U.S. Securities and Exchange Commission or SEC. We define Adjusted EBITDA as net income adjusted for interest expense, depreciation and amortization

 

 

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expense, income tax expense, stock-based compensation and related tax reimbursements, litigation settlement and restructuring charges and acquisition related de novo startup expenses, which includes professional services for accounting, legal and valuation services related to the acquisitions and legal and licensing expenses related to de novo projects. Adjusted EBITDA, as presented in this prospectus, is considered a supplemental measure of our performance and is not required by, or presented in accordance with, generally accepted accounting principles in the United States or GAAP. Adjusted EBITDA is not a measure of our financial performance under GAAP and should not be considered as an alternative to net income or any other performance measures derived in accordance with GAAP. We have included information concerning Adjusted EBITDA in this prospectus because we believe that such information is used by certain investors as a measure of a company’s historical performance. We believe this measure is frequently used by securities analysts, investors and other interested parties in the evaluation of issuers of equity securities, many of which present EBITDA and Adjusted EBITDA when reporting their results. Because Adjusted EBITDA is not determined in accordance with GAAP, it is subject to varying calculations and may not be comparable to the Adjusted EBITDA (or similarly titled measures) of other companies. Our presentation of Adjusted EBITDA should not be construed as an inference that our future results will be unaffected by unusual or nonrecurring items. The following table presents a reconciliation of Adjusted EBITDA to net income, the most comparable GAAP measure, for each of the periods indicated:

 

                Year Ended December 31, 2013     Six
Months
Ended
June 30,
         2013        
Actual
(unaudited)
    Six Months Ended June 30, 2014  
    Year Ended
December 31,
          Pro Forma
as Adjusted
    Pro Forma
as Adjusted
including
CRMS
Acquisition
      Actual
(unaudited)
    Pro Forma
as Adjusted
    Pro Forma
as Adjusted
including
CRMS
Acquisition
 
    2011     2012     Actual              
    (in thousands)  

Net Income

  $ 871      $ 1,099      $ 1,492      $                   $                   $ 1,981      $ 1,068      $                   $                

Non-GAAP Adjustments:

                 

Interest expense

    337        980        1,390            784        705       

Depreciation and amortization

    195        1,288        3,003            1,399        2,228       

Income tax expense

    652        1,148        615            1,745        859       

Stock-based compensation and related tax reimbursements

           2,408        1,649            605        1,776       

Litigation settlement

                  2,588            2,500        240       

Restructuring

                  806            551              

Acquisition related and de novo start-up expenses

           245        15            15        956       
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA

  $ 2,055      $ 7,168      $ 11,558      $                   $                   $ 9,580      $ 7,832      $                   $                
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

(7) Reflects the issuance of             shares of Holdings common stock at the initial public offering price of $             per share (the midpoint of the price range set forth on the cover page of this prospectus) and the estimated net proceeds of $             and a use of a portion of the proceeds to repay approximately $             million of outstanding indebtedness. Each $1.00 increase or decrease in the assumed initial public offering price of $             per share, the midpoint of the price range set forth on the cover page of this prospectus, would increase or decrease, as applicable, our cash and cash equivalents, working capital, total assets and total stockholders’ equity by approximately $             million, assuming the number of shares offered by us, as set forth on the cover page of this prospectus, remains the same and after deducting estimated underwriting discounts and commissions and estimated offering expenses payable by us.

(8) For additional discussion of mezzanine equity and noncontrolling interest, see Note 11 to our audited financial statements included elsewhere in this prospectus.

(9) Noncontrolling interest represents the equity of BHR (through April 15, 2014) and the Professional Groups (as defined in “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Consolidation of VIEs”) that we do not own as well as the outstanding shares of AAC common stock that were not exchanged for shares of Holdings common stock.

(10) Includes client census at all of our owned or leased inpatient facilities, including FitRx, as well as beds obtained through contractual arrangements to meet demand exceeding capacity. For additional information about contracted beds, see “Revenues” under Note 3 to our audited financial statements included elsewhere in this prospectus.

(11) Average daily revenue is calculated as total revenues during the period divided by the product of the number of days in the period multiplied by average daily census.

(12) Average net daily revenue is calculated as total revenues less provision for doubtful accounts during the period dividend by the product of the number of days in the period multiplied by average daily census.

(13) Includes total client admissions for the period presented.

 

 

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(14) Bed count at end of period includes all beds at owned and leased inpatient facilities, including FitRx, but excludes contracted beds as of December 31, 2012. We did not have any contracted beds as of any other period presented. Bed count at the end of the 2012 period includes 70 beds at our former Leading Edge facility, which was closed in the second quarter of 2013. For additional information regarding the closure of the Leading Edge facility, see Note 13 to our audited financial statements included elsewhere in this prospectus. In the first quarter of 2014, we added two beds at the FitRx facility to accommodate increased client census and eliminated six beds at The Academy facility as a result of an expired housing lease. In addition, the Greenhouse expansion, completed in July 2014, added 60 beds, all of which are licensed for detoxification.

 

 

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RISK FACTORS

Investing in our common stock involves a high degree of risk. You should carefully consider the risk factors discussed below, as well as the other information presented in this prospectus, in evaluating us, our business and an investment in our common stock. If any of the matters highlighted by the following risks actually occur, our business, financial condition, results of operations, cash flows and prospects could be materially and adversely affected. As a result, the trading price of our common stock could decline and you could lose all or part of your investment in our common stock. See “Special Note Regarding Forward-Looking Statements.”

Risks Related to Our Business

Our revenues, profitability and cash flows could be materially adversely affected if we are unable to operate certain key treatment facilities, our corporate office or our laboratory facility.

We derive a significant portion of our revenues from three treatment facilities located in California, Nevada and Texas. These treatment facilities accounted for 76.5% of our total revenues in 2013 and 81.5% for the six months ended June 30, 2014. It is likely that a small number of facilities will continue to contribute a significant portion of our total revenues in any given year for the foreseeable future. Additionally, we have a centralized corporate office that houses our accounting, billing and collections, information technology, marketing and call center departments and a high complexity laboratory facility that conducts quantitative drug testing and other laboratory services. If any event occurs that would result in a complete or partial shutdown of any of these facilities or our centralized corporate office or laboratory, including, without limitation, any material changes in legislative, regulatory, economic, environmental or competitive conditions in these states or natural disasters such as hurricanes, earthquakes, tornadoes or floods or prolonged airline disruptions for any reason, such event could lead to decreased revenues and/or higher operating costs, which could have a material adverse effect on our revenues, profitability and cash flows.

We rely on our multi-faceted sales and marketing program to continuously attract and enroll clients to our network of facilities. Any disruption in our national sales and marketing program would have a material adverse effect on our business, financial condition and results of operations.

We believe our national sales and marketing program provides us with a competitive advantage compared to treatment facilities that primarily target local geographic areas and use fewer marketing channels to attract clients. If any disruption occurs in our national sales and marketing program for any reason or if we are unable to effectively attract and enroll new clients to our network of facilities, our ability to maintain census could be adversely affected, which would have a material adverse effect on our business, financial condition and results of operations.

In addition, our ability to grow or even to maintain our existing level of business depends significantly on our ability to establish and maintain close working and referral relationships with hospitals, other treatment facilities, employers, alumni, employee assistance programs and other referral sources. We have no binding commitments with any of these referral sources. We may not be able to maintain our existing referral relationships or develop and maintain new relationships in existing or new markets. If we lose existing relationships with our referral sources, the number of people to whom we provide services may decline, which may adversely affect our revenues. Also, if we fail to develop new referral relationships, our growth may be restrained.

We derive a significant portion of our revenues from providing services to clients covered by third-party payors who could reduce their reimbursement rates or otherwise restrain our ability to obtain, or provide services to, clients. This risk is heightened because we are generally an “out-of-network” provider.

Managed care organizations and other third-party payors pay for the services that we provide to many of our clients. For 2013 and the six months ended June 30, 2014, approximately 90% of our revenues were reimbursable by third-party payors, including amounts paid by such payors to clients, with the remaining portion payable directly by our clients. If any of these third-party payors reduce their reimbursement rates or elect not to cover some or all of our services, our business, financial condition and results of operations may decline.

 

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In addition to limiting the amounts payors will pay for the services we provide to their members, controls imposed by third-party payors designed to reduce admissions and the length of stay for clients, commonly referred to as “utilization review,” have affected and are expected to continue to affect our facilities. Utilization review entails the review of the admission and course of treatment of a client by third-party payors. Inpatient utilization, average lengths of stay and occupancy rates continue to be negatively affected by payor-required preadmission authorization and utilization review and by payor pressure to maximize outpatient and alternative healthcare delivery services for less acutely ill clients. Efforts to impose more stringent cost controls are expected to continue. Although we are unable to predict the effect these controls and changes will have on our operations, significant limits on the scope of services reimbursed and on reimbursement rates and fees could have a material adverse effect on our business, financial condition and results of operations.

Changes to government healthcare programs, principally Medicare and Medicaid, have resulted in limitations on reimbursement and, in some cases, reduced levels of reimbursement for healthcare services in recent years. In particular, recent governmental measures to regulate clinical laboratory services have resulted in reduced prices, added costs and decreased test utilization. Although we do not currently bill Medicare or any other government healthcare program for our laboratory or other substance abuse treatment services, there is a risk that third-party commercial payors may implement similar changes. If the rates paid or the scope of laboratory or other substance abuse treatment services covered by third-party commercial payors are reduced, our business, financial condition and results of operations could be materially adversely affected.

We are considered an “out-of-network” provider with respect to the vast majority of third-party payors, and, therefore, we bill our full charges for services covered by such third-party payors. Third-party payors will generally attempt to limit use of out-of-network providers by requiring clients to pay higher copayment and/or deductible amounts for out-of-network care. Additionally, third-party payors have become increasingly aggressive in attempting to minimize the use of out-of-network providers by disregarding the assignment of payment from clients to out-of-network providers (i.e., sending payments to clients instead of out-of-network providers), capping out-of-network benefits payable to clients, waiving out-of-pocket payment amounts and initiating litigation against out-of-network providers for interference with contractual relationships, insurance fraud and violation of state licensing and consumer protection laws. If third-party payors impose further restrictions on out-of-network providers, our revenues could be threatened, forcing our facilities to participate with third-party payors and accept lower reimbursement rates compared to our historic reimbursement rates.

Third-party payors also are entering into sole source contracts with some healthcare providers, which could effectively limit our pool of potential clients. Moreover, third-party payors are beginning to carve out specific services, including substance abuse treatment services, and establish small, specialized networks of providers for such services at fixed reimbursement rates. Continued growth in the use of carve-out arrangements could materially adversely affect our business to the extent we are not selected to participate in such smaller specialized networks or if the reimbursement rate is not adequate to cover the cost of providing the service.

An increase in uninsured and underinsured clients or the deterioration in the collectability of the accounts of such clients could have a material adverse effect on our business, financial condition and results of operations.

Collection of receivables from third-party payors and clients is critical to our operating performance. Our primary collection risks are (i) the risk of overestimating our net revenues at the time of billing that may result in us receiving less than the recorded receivable, (ii) the risk of non-payment as a result of commercial insurance companies denying claims, (iii) the risk that clients will fail to remit insurance payments to us when the commercial insurance company pays out-of-network claims directly to the client, (iv) resource and capacity constraints that may prevent us from handling the volume of billing and collection issues in a timely manner and (v) the risk of non-payment from uninsured clients. Additionally, our ability to hire and retain experienced personnel also affects our ability to bill and collect accounts in a timely manner. We establish our provision for doubtful accounts based on the aging of the receivables and taking into consideration historical collection experience by facility, services provided, payor source and historical reimbursement rate, current economic trends and

 

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percentages applied to the accounts receivable aging categories. At December 31, 2013 and June 30, 2014, our allowance for doubtful accounts represented approximately 35.2% and 39.2%, respectively, of our accounts receivable balance as of such date, with three and two commercial payors each representing in excess of 10% of the accounts receivable balance as of December 31, 2013 and June 30, 2014, respectively. We routinely review accounts receivable balances in conjunction with these factors and other economic conditions that might ultimately affect the collectability of the client accounts and make adjustments to our allowances as warranted. Significant changes in business office operations, payor mix or economic conditions, including changes resulting from implementation of the Affordable Care Act, could affect our collection of accounts receivable, cash flows and results of operations. In addition, increased client concentration in states that permit commercial insurance companies to pay out-of-network claims directly to the client instead of us, such as California and Nevada, will adversely affect our collection of receivables. If we experience unexpected increases in the growth of uninsured and underinsured clients or in our provision for doubtful accounts or unexpected changes in reimbursement rates by third-party payors, it could have a material adverse effect on our business, financial condition and results of operations.

If we overestimate the reimbursement amounts that payors will pay us for services performed, it would increase our revenue adjustments, which could have a material adverse effect on our revenues, profitability and cash flows and lead to significant shifts in our results of operations from quarter to quarter that may make it difficult to project long-term performance.

We recognize revenues from commercial payors at the time services are provided based on our estimate of the amount that payors will pay us for the services performed. We estimate the net realizable value of revenues by adjusting gross client charges using our expected realization and applying this discount to gross client charges. Through December 31, 2013, our expected realization was determined by management after taking into account historical collections received from the commercial payors since our inception compared to the gross client charges billed. Beginning in January 2014, we enhanced the methodology related to our net realizable value to more quickly react to potential changes in reimbursements by facility, by type of service and by payor. As a result, management adjusted the expected realization discount, on a per facility basis, to reflect a twelve-month historical analysis of reimbursement data by facility in addition to considering the type of services provided, the payors and the gross client charge rates by facility. This adjustment resulted in a decrease in our expected realization for the first half of 2014. Although we are unable to quantify the future effects of this change in methodology, we currently anticipate this adjustment will decrease our expected realization and net realizable value of revenues over the remainder of 2014.

During the six months ended June 30, 2014, we experienced a decline in our collection rates as expressed as a percentage of gross client charges. For additional information, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Results of Operations—Comparison of Six Months ended June 30, 2014 to Six Months ended June 30, 2013—Revenues.” A significant or sustained decrease in our collection rates could have a material adverse effect on our operating results. There is no assurance that we will be able to maintain or improve historical collection rates in future reporting periods.

Estimates of net realizable value are subject to significant judgment and approximation by management. It is possible that actual results could differ from the historical estimates management has used to help determine the net realizable value of revenues. If our actual collections either exceed or are less than the net realizable value estimates, we will record a revenue adjustment, either positive or negative, for the difference between our estimate of the receivable and the amount actually collected in the reporting period in which the collection occurred. A significant negative revenue adjustment could have a material adverse effect on our revenues, profitability and cash flows in the reporting period in which such adjustment is recorded. In addition, if we record a significant revenue adjustment, either positive or negative, in any given reporting period, it may lead to significant shifts in our results from operations from quarter to quarter, which may limit our ability to make accurate long-term predictions about our future performance.

 

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Certain third-party payors account for a significant portion of our revenues, and the reduction of reimbursement rates by any such payor could have a material adverse effect on our revenues, profitability and cash flows.

For the year ended December 31, 2013, approximately 12.3% of our revenue reimbursements came from Blue Cross Blue Shield of California, 12.1% came from Aetna, and 10.3% came from United Behavioral Health. No other payor accounted for more than 10% of our revenue reimbursements for the year ended December 31, 2013. For the six months ended June 30, 2014, approximately 14.5% of our revenue reimbursements came from Anthem Blue Cross Blue Shield of Colorado, 12.5% came from Blue Cross Blue Shield of California, 12.3% came from Aetna and 10.4% came from Blue Cross Blue Shield of Texas. No other payor accounted for more than 10% of our revenue reimbursements for the six months ended June 30, 2014. If any of these or other third-party payors reduce their reimbursement rates for the services we provide, our revenues, profitability and cash flows could be materially adversely affected.

Our level of indebtedness could adversely affect our ability to meet our obligations under our indebtedness, react to changes in the economy or our industry and to raise additional capital to fund our operations.

As of June 30, 2014, we had total debt of $46.8 million outstanding, including $13.0 million of indebtedness with respect to our revolving line of credit that we intend to pay down with the net proceeds from this offering. We have historically relied on debt financing to fund our real estate development and our operating cash flow requirements, and we expect such debt financing needs to continue. A summary of the material terms of our indebtedness can be found in “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Liquidity and Capital Resources.” Our level of indebtedness could have important consequences to our stockholders. For example, it could:

 

    make it more difficult for us to satisfy our obligations with respect to our indebtedness, resulting in possible defaults on, and acceleration of, such indebtedness;

 

    increase our vulnerability to general adverse economic and industry conditions;

 

    require us to dedicate a substantial portion of our cash flows from operations to payments on indebtedness, thereby reducing the availability of such cash flows to fund working capital, capital expenditures and other general corporate requirements or to carry out other aspects of our business;

 

    limit our ability to obtain additional financing to fund future working capital, capital expenditures and other general corporate requirements or to carry out other aspects of our business;

 

    limit our ability to make material acquisitions or take advantage of business opportunities that may arise; and

 

    place us at a potential competitive disadvantage compared to our competitors that have less debt.

Our operating flexibility is limited in significant respects by the restrictive covenants in our amended and restated credit facility, and we have breached such covenants in the past and may be unable to comply with such covenants in the future.

Our Second Amended and Restated Credit Facility (the “Credit Facility”) imposes restrictions that could impede our ability to enter into certain corporate transactions, as well as increases our vulnerability to adverse economic and industry conditions, by limiting our flexibility in planning for, and reacting to, changes in our business and industry. These restrictions limit our and our subsidiaries’ ability to, among other things:

 

    incur or guarantee additional debt;

 

    pay dividends on our capital stock or redeem, repurchase, retire or otherwise acquire any of our capital stock;

 

    make certain capital expenditures;

 

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    enter into leases;

 

    make certain payments or investments;

 

    create liens on our assets;

 

    make any substantial change in the nature of our business as it is currently conducted; and

 

    merge or consolidate with other companies or transfer all or substantially all of our assets.

In addition, our Credit Facility requires us to meet certain financial covenants. The restrictions may prevent us from taking actions that we believe would be in the best interests of our business and may make it difficult for us to successfully execute our business strategy or effectively compete with companies that are not similarly restricted. Our Credit Facility also contains cross-default provisions that apply to loans made pursuant to the Credit Facility and to any other material indebtedness we may have. We may also incur future debt obligations that might subject us to additional restrictive covenants that could affect our financial and operational flexibility. Our ability to comply with these covenants in future periods will largely depend on our ability to successfully implement our overall business strategy. In April 2014, in connection with the amendment and restatement of our prior credit facility, we received waivers from previous periods of noncompliance with certain financial covenants and other negative covenants under that prior credit facility. We cannot assure you that we will be granted any further waivers or amendments to the Credit Facility if for any reason we are unable to comply with the terms of the Credit Facility in the future. The breach of any of these covenants or restrictions could result in a default under the Credit Facility, which could result in the acceleration of our debt. In the event of an acceleration of debt, we could be forced to apply all available cash flows to repay such debt and could be forced into bankruptcy or liquidation.

We will need additional financing to execute our business plan and fund operations, which additional financing may not be available on reasonable terms or at all.

As of June 30, 2014, we had $3.7 million of working capital. Our acquisition and de novo development strategies will require substantial additional capital. We will consider raising additional funds through various financing sources, including the sale of our equity and debt securities and the procurement of commercial debt financing. However, there can be no assurance that such funds will be available on commercially reasonable terms, if at all. If such financing is not available on satisfactory terms, we may be unable to expand or continue our business as desired and operating results may be adversely affected. Any debt financing will increase expenses and must be repaid regardless of operating results and may involve restrictions limiting our operating flexibility. If we issue equity securities to raise additional funds, the percentage ownership of our existing stockholders will be reduced, and our stockholders may experience additional dilution in net book value per share.

Our ability to obtain needed financing may be impaired by such factors as the capital markets, both generally and specifically in our industry, which could impact the availability or cost of future financings. If the amount of capital we are able to raise from financing activities, together with our revenues from operations, is not sufficient to satisfy our capital needs, we may be required to decrease the pace of, or eliminate, our acquisition strategy and potentially reduce or even cease operations.

Our business may face significant risks with respect to future de novo expansion, including the time and costs of identifying new geographic markets, the ability to obtain necessary licensure and other zoning or regulatory approvals and significant start-up costs including advertising, marketing and the costs of providing equipment, furnishings, supplies and other capital resources.

As part of our growth strategy, we intend to develop new substance abuse treatment facilities in existing and new markets, either by building a new facility from the ground up or acquiring an existing facility with an alternative use and repurposing it as a substance abuse treatment facility. Such de novo expansion involves significant risks, including, but not limited to, the following:

 

    identifying locations in suitable geographic markets can be a lengthy and costly process;

 

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    a change in existing comprehensive zoning plans or zoning regulations that imposes additional restrictions on use or requirements could impact our expansion into otherwise suitable geographic markets;

 

    the de novo facility may require significant advertising and marketing expenditures to attract clients;

 

    we will need to provide each de novo facility with the appropriate equipment, furnishings, materials, supplies and other capital resources;

 

    our ability to obtain licensure, obtain accreditation, establish relationships with healthcare providers in the community and delays or difficulty in installing our operating and information systems;

 

    the time and costs of evaluating new markets, hiring experienced local physicians, management and staff and opening new facilities, and the time lags between these activities and the generation of sufficient revenues to support the costs of the expansion; and

 

    our ability to finance de novo expansion and possible dilution to our existing stockholders if our common stock is used as consideration.

As a result of these risks, there can be no assurance that a de novo treatment facility will become profitable.

Our acquisition strategy exposes us to a variety of operational and financial risks, which may have a material adverse effect on our business, financial condition and results of operations.

A principal element of our business strategy is to grow by acquiring other companies and assets in the mental health and substance abuse treatment industry. We evaluate potential acquisition opportunities consistent with the normal course of our business. Our ability to complete acquisitions is subject to a number of risks and variables, including our ability to negotiate mutually agreeable terms with the counterparties and our ability to finance the purchase price. We may not be successful in identifying and consummating suitable acquisitions, which may impede our growth and negatively affect our results of operations and may also require a significant amount of management resources. In addition, growth, especially rapid growth, through acquisitions exposes us to a variety of operational and financial risks. We summarize the most significant of these risks below.

Integration risks . We must integrate our acquisitions with our existing operations. This process includes the integration of the various components of our business and of the businesses we have acquired or may acquire in the future, including the following:

 

    physicians and employees who are not familiar with our operations;
    regulatory compliance programs; and
    disparate operating, information and record keeping systems and technology platforms.

The integration of acquisitions with our operations could be expensive, require significant attention from management, may impose substantial demands on our operations or other projects and may impose challenges on the combined business including, without limitation, consistencies in business standards, procedures, policies and business cultures.

Benefits may not materialize . When evaluating potential acquisition targets, we identify potential synergies and cost savings that we expect to realize upon the successful completion of the acquisition and the integration of the related operations. We may, however, be unable to achieve or may otherwise never realize the expected benefits. If we do not achieve our expected results, it may adversely impact our results of operations.

Assumptions of unknown liabilities. Facilities that we acquire may have unknown or contingent liabilities, including, without limitation, liabilities for failure to comply with healthcare laws and regulations. Although we typically attempt to exclude significant liabilities from our acquisition transactions and seek indemnification from the sellers of such facilities for at least a portion of these matters, we may experience diffi-

 

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culty enforcing those indemnification obligations, or we may incur material liabilities for the past activities of acquired facilities. Such liabilities and related legal or other costs and/or resulting damage to a facility’s reputation could negatively impact our business.

Competing for acquisitions. We face competition for acquisition candidates primarily from other for-profit healthcare companies as well as from not-for-profit entities. Some of our competitors have greater resources than we do. As a result, we may pay more to acquire a target business or may agree to less favorable deal terms than we would have otherwise. Also, suitable acquisitions may not be accomplished due to unfavorable terms. Further, the cost of an acquisition could result in a dilutive effect on our results of operations, depending on various factors, including the amount paid for an acquired facility, the acquired facility’s results of operations, the fair value of assets acquired and liabilities assumed, effects of subsequent legislation and limits on reimbursement rate increases.

Managing growth. Some of the facilities we have acquired or may acquire in the future may have had significantly lower operating margins than the facilities we operated prior to the time of our acquisition thereof or had operating losses prior to such acquisition. If we fail to improve the operating margins of the facilities we acquire, operate such facilities profitably or effectively integrate the operations of acquired facilities, our results of operations could be negatively impacted.

Our ability to maintain census and the average length of stay of our clients is dependent on a number of factors outside of our control, and if we are unable to maintain census, or if we experience a significant decrease in average length of stay, our business, results of operations and cash flows could be materially adversely affected.

Our revenues are directly impacted by our ability to maintain census and, to a lesser extent, the average length of stay of our clients. These metrics are dependent on a variety of factors, many of which are outside of our control, including the effectiveness of our sales and marketing efforts, our referral relationships, our staffing levels and facility capacity, the extent to which third-party payors require preadmission authorization or utilization review controls, competition in the industry and the decisions of our clients to seek and commit to treatment. A significant decrease in census or, to a lesser extent, average length of stay could materially adversely affect our revenues, profitability and cash flows due to lower reimbursements received and the additional resources required to collect accounts receivable and to maintain our existing level of business.

Given the client-driven nature of the substance abuse treatment sector, our business is dependent on clients seeking and committing to treatment. Although increased awareness and de-stigmatization of substance abuse treatment in recent years has resulted in more people seeking treatment, the decision of each client to seek treatment is ultimately discretionary. In addition, even after the initial decision to seek treatment is made, our adult clients may decide at any time to discontinue treatment and leave our facilities against the advice of our physicians and other treatment professionals. For this reason, among others, average length of stay can vary among periods without correlating to the overall operating performance of our business, and as a result, management does not view average length of stay as a key metric with respect to our operating performance. However, if clients or potential clients decide not to seek treatment or discontinue treatment early, census and average length of stay could decrease and, as a result, our business, financial condition and results of operations could be adversely affected.

As a provider of treatment services, we are subject to governmental investigations and potential claims and legal actions by clients, employees and others, which may increase our costs and have a material adverse effect on our business, financial condition and results of operations.

Given the addiction and mental health of clients and the services provided, the substance abuse treatment industry is heavily regulated by governmental agencies and involves significant risk of liability. We and others in our industry are exposed to the risk of governmental investigations and lawsuits or other claims against us and our

 

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physicians and professionals arising out of our day to day business operations, including, without limitation, client treatment at our facilities and relationships with healthcare providers that may refer clients to us. Addressing any investigations, lawsuits or other claims may distract management and divert resources. Fines, restrictions and penalties imposed as a result of an investigation or a successful lawsuit or claim that is not covered by, or is in excess of, our insurance coverage may increase our costs and reduce our profitability. Our insurance premiums have increased year over year, and insurance coverage may not be available at a reasonable cost, especially given the significant increase in insurance premiums generally experienced in the healthcare industry.

We are also subject to potential medical malpractice lawsuits and other legal actions in the ordinary course of business. Some of these actions may involve large claims as well as significant defense costs. We cannot predict the outcome of these lawsuits or the effect that findings in such lawsuits may have on us. All professional and general liability insurance we purchase is subject to policy limitations. We believe that, based on our past experience, our insurance coverage is adequate considering the claims arising from the operation of our facilities. While we continuously monitor our coverage, our ultimate liability for professional and general liability claims could change materially from our current estimates. If such policy limitations should be partially or fully exhausted in the future or if payments of claims exceed our estimates or are not covered by our insurance, it could have a material adverse effect on our financial condition and results of operations.

We operate in a highly competitive industry, and competition may lead to declines in client volumes and an increase in labor costs, which could have a material adverse effect on our business, financial condition and results of operations.

The substance abuse treatment industry is highly competitive, and competition among substance abuse treatment providers (including behavioral healthcare facilities) for clients has intensified in recent years. There are other behavioral healthcare facilities that provide substance abuse and other mental health treatment services comparable to at least some of those offered by our facilities in each of the geographical areas in which we operate. Some of our competitors are owned by tax-supported governmental agencies or by nonprofit corporations and may have certain financial advantages not available to us, including endowments, charitable contributions, tax-exempt financing and exemptions from sales, property and income taxes. If our competitors are better able to attract clients, expand services or obtain favorable participation agreements at their facilities, we may experience a decline in client volume, and it could have a material adverse effect on our business, financial condition and results of operations.

Our operations depend on the efforts, abilities and experience of our management team, physicians and medical support personnel, including our nurses, mental health technicians, therapists and counselors. We compete with other healthcare providers in recruiting and retaining qualified management, nurses and other support personnel responsible for the daily operations of our facilities.

The nationwide shortage of nurses and other medical support personnel has been a significant operating issue facing us and other healthcare providers. This shortage may require us to enhance wages and benefits to recruit and retain nurses and other medical support personnel or require us to hire more expensive temporary or contract personnel. In addition, certain of our facilities are required to maintain specified nurse-staffing levels. To the extent we cannot meet those levels, we may be required to limit the services provided by these facilities, which could have a corresponding adverse effect on our net operating revenues.

Increased labor union activity is another factor that could adversely affect our labor costs. Although we are not aware of any union organizing activity at any of our facilities, we are unable to predict whether any such activity will take place in the future. To the extent that a portion of our employee base unionizes, it is possible that our labor costs could increase materially.

We cannot predict the degree to which we will be affected by the future availability or cost of attracting and retaining talented medical support staff. If our general labor and related expenses increase, we may not be able to raise our rates correspondingly. Our failure to either recruit and retain qualified management, nurses and

 

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other medical support personnel or control our labor costs could have a material adverse effect on our business, financial condition and results of operations.

We depend heavily on key management personnel, and the departure of one or more of our key executives or a significant portion of our local facility management personnel or sales force could have a material adverse effect on our business, financial condition and results of operations.

The expertise and efforts of our key executives, including our chief executive officer, president, chief operating officer, chief financial officer and general counsel, and other key members of our facility management personnel and sales staff are critical to the success of our business. We do not currently have employment agreements or non-competition covenants with any of our key executives. The loss of the services of one or more of our key executives or of a significant portion of our facility management personnel or sales staff could significantly undermine our management expertise and our ability to provide efficient, quality healthcare services at our facilities. Furthermore, if one or more of our key executives were to terminate employment with us and engage in a competing business, we would be subject to increased competition, which could have a material adverse effect on our business, financial condition and results of operations.

Failure to achieve and maintain effective internal control over financial reporting in accordance with Section 404 of the Sarbanes-Oxley Act of 2002, or Sarbanes-Oxley, could have a material adverse effect on our business.

Historically, as a privately-held company, we were not required to maintain internal control over financial reporting in a manner that meets the standards of publicly traded companies required by Section 404 of Sarbanes-Oxley. As a public company, we will be required to meet these standards in the course of preparing our consolidated financial statements. If we are unable to maintain effective internal control over financial reporting, we may be unable to report our financial information on a timely basis, may suffer adverse regulatory consequences or violations of applicable stock exchange listing rules and may breach the covenants under our Credit Facility. There could also be a negative reaction in the financial markets due to a loss of investor confidence in us and the reliability of our financial statements. Confidence in our financial statements is also likely to suffer if we report a material weakness in our internal control over financial reporting. In addition, we will incur incremental costs in order to improve our internal control over financial reporting and comply with Section 404 of Sarbanes-Oxley, including increased auditing and legal fees.

A cyber security incident could cause a violation of the Health Insurance Portability and Accountability Act of 1996, or HIPAA, breach of client privacy or other negative impacts.

A cyber-attack that bypasses our information technology (“IT”) security systems causing an IT security breach, loss of individually identifiable health information or other data subject to privacy laws, loss of proprietary business information or a material disruption of our IT business systems, could have a material adverse impact on our business, financial condition and results of operations. In addition, our future results of operations, as well as our reputation, could be adversely impacted by theft, destruction, loss or misappropriation of individually identifiable health information, other confidential data or proprietary business information.

Failure to adequately protect our trademarks and any other proprietary rights could have a material adverse effect on our business, financial condition and results of operations.

We maintain a trademark portfolio that we consider to be of significant importance to our business. If the actions we take to establish and protect our trademarks and other proprietary rights are not adequate to prevent imitation of our services by others or to prevent others from seeking to block sales of our services as an alleged violation of their trademarks and proprietary rights, it may be necessary for us to initiate or enter into litigation in the future to enforce our trademark rights or to defend ourselves against claimed infringement of the rights of others. Any legal proceedings could result in an adverse determination that could have a material adverse effect on our business, financial condition and results of operations.

 

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Risks Related to Regulatory Matters

If we fail to comply with the extensive laws and government regulations impacting our industry, we could suffer penalties, be the subject of federal and state investigations or be required to make significant changes to our operations, which may reduce our revenues, increase our costs and have a material adverse effect on our business, financial condition and results of operations.

Healthcare service providers are required to comply with extensive and complex laws and regulations at the federal, state and local government levels relating to, among other things:

 

    licensure, certification and accreditation of substance abuse treatment services;

 

    Clinical Laboratory Improvement Amendments (“CLIA”) certification and state licensure of laboratory services;

 

    handling, administration and distribution of controlled substances;

 

    necessity and adequacy of care, quality of services, and qualifications of professional and support personnel;

 

    referrals of clients and permissible relationships with physicians and other referral sources;

 

    billings for reimbursement from commercial payors;

 

    consumer protection issues and billing and collection of client-owed accounts issues;

 

    privacy and security issues associated with health-related information, client personal information and medical records, including their use and disclosure, client notices, adequate security safeguards and the handling of breaches, complaints and accounting for disclosures;

 

    physical plant planning, construction of new facilities and expansion of existing facilities;

 

    activities regarding competitors;

 

    state corporate practice of medicine, fee-splitting, self-referral and kickback prohibitions; and

 

    claim submission and collections, including penalties for the submission of, or causing the submission of, false, fraudulent or misleading claims.

Failure to comply with these laws and regulations could result in the imposition of significant civil or criminal penalties, loss of license or certification or require us to change our operations, which may have a material adverse effect on our business, financial condition and results of operations. Both federal and state government agencies as well as commercial payors have heightened and coordinated civil and criminal enforcement efforts as part of numerous ongoing investigations of healthcare organizations.

We endeavor to comply with all applicable legal and regulatory requirements, however, there is no guarantee that we will be able to adhere to all of the complex government regulations that apply to our business. In this regard, we seek to structure all of our relationships with physicians to comply with applicable anti-kickback laws, physician self-referral laws, and state corporate practice of medicine prohibitions. We monitor these laws and implement changes as necessary. However, the laws and regulations in these areas are complex and often subject to varying interpretations. For example, if an enforcement agency were to challenge the compensation paid under our contracts with professional physician groups, we could be required to change our practices, face criminal or civil penalties, pay substantial fines or otherwise experience a material adverse effect as a result of a challenge to these arrangements.

We may be required to spend substantial amounts to comply with legislative and regulatory initiatives relating to privacy and security of client health information.

There are currently numerous legislative and regulatory initiatives at the federal and state levels addressing client privacy and security concerns. In particular, federal regulations issued under the Drug Abuse Pre-

 

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vention, Treatment and Rehabilitation Act of 1979 strictly restrict the disclosure of client identifiable information related to substance abuse and apply to any of our facilities that receive any federal assistance, which is interpreted broadly to include facilities licensed, certified or registered by a federal agency. In addition, the federal privacy and security regulations issued under HIPAA require our facilities to comply with extensive administrative requirements on the use and disclosure of individually identifiable health information (known as “protected health information”) and require covered entities, which include most healthcare providers, to implement and maintain administrative, physical and technical safeguards to protect the security of such information. Additional security requirements apply to electronic protected health information. These regulations also provide clients with substantive rights with respect to their health information and impose substantial administrative obligations on our facilities, including the requirement to enter into written agreements with contractors to whom our programs disclose protected health information. In 2013, the U.S. Department of Health and Human Services, or HHS, published revisions to the HIPAA privacy and security regulations which require our facilities to take additional compliance measures, including revising and entering into new contractor agreements and implementing procedures to comply with more onerous standards related to notifying individuals, HHS and, in some cases, the media of breaches involving unsecured protected health information. These regulations also implemented a number of provisions that gave HHS greater enforcement authority. Violations of the HIPAA privacy and security regulations may result in significant civil and criminal penalties and data breaches and other HIPAA violations may give rise to class action lawsuits by affected clients under state law.

Our programs remain subject to any privacy-related federal or state laws that are more restrictive than the HIPAA privacy and security regulations. These laws vary by state and could impose additional requirements and penalties. For example, some states impose strict restrictions on the use and disclosure of health information pertaining to mental health or substance abuse. Further, most states have enacted laws and regulations that require us to notify affected individuals in the event of a data breach involving individually identifiable information. In addition, the Federal Trade Commission may use its consumer protection authority to initiate enforcement actions in response to data breaches.

As public attention is drawn to issues related to the privacy and security of medical and other personal information, federal and state authorities may increase enforcement efforts, seek to impose harsher penalties as well as revise and expand laws or enact new laws concerning these topics. Compliance with current as well as any newly established provisions or interpretations of existing requirements will require us to expend significant resources. Increased focus on privacy and security issues by enforcement authorities may increase the overall risk that our substance abuse treatment facilities may be found lacking under federal and state privacy and security laws and regulations.

Our treatment facilities operate in an environment of increasing state and federal enforcement activity and private litigation targeted at healthcare providers.

Both federal and state government agencies have heightened and coordinated their civil and criminal enforcement efforts as part of numerous ongoing investigations of healthcare companies and various segments of the healthcare industry. These investigations relate to a wide variety of topics, including relationships with physicians, billing practices and use of controlled substances. The Affordable Care Act included an additional $350 million of federal funding over 10 years to fight healthcare fraud, waste and abuse, including $40 million for federal fiscal year 2014. From time to time, the Office of Inspector General and the Department of Justice have established national enforcement initiatives that focus on specific billing practices or other suspected areas of abuse. Although we do not currently bill Medicare or any other federal healthcare program for substance abuse treatment services, there is a risk that specific investigation initiatives could be expanded to include our treatment facilities. In addition, increased government enforcement activities, even if not directed towards our treatment facilities, also increase the risk that our facilities, physicians and other clinicians furnishing services in our facilities, or our executives and directors, could become named as defendants in private litigation such as state or federal false claims act cases or consumer protection cases, or could become the subject of complaints at the various state and federal agencies that have jurisdiction over our operations. Any governmental investigations,

 

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private litigation or other legal proceedings involving any of our facilities, our executives or our directors, even if we ultimately prevail, could result in significant expense and could adversely affect our reputation. In addition, we may be required to make changes in our laboratory or other substance abuse treatment services as a result of an adverse determination in any governmental enforcement action, private litigation or other legal proceeding, which could materially adversely affect our business and results of operations.

Changes to federal, state and local regulations, as well as different or new interpretations of existing regulations, could adversely affect our operations and profitability.

Because our treatment programs and operations are regulated at federal, state and local levels, we could be affected by different regulatory changes in different regional markets. Increases in the costs of regulatory compliance and the risks of noncompliance may increase our operating costs, and we may not be able to recover these increased costs, which may adversely affect our results of operations and profitability.

Also, because many of the current laws and regulations are relatively new, we do not always have the benefit of significant regulatory or judicial interpretation of these laws and regulations. In the future, different interpretations or enforcement of these laws and regulations could subject our current or past practices to allegations of impropriety or illegality or could require us to make changes in our treatment facilities, equipment, personnel, services or capital expenditure programs. A determination that we have violated these laws, or the public announcement that we are being investigated for possible violations of these laws, could adversely affect our business, operating results and overall reputation in the marketplace.

In addition, federal, state and local regulations may be enacted that impose additional requirements on our facilities, such as the 2013 changes to the HIPAA privacy and security regulations. Adoption of legislation or the creation of new regulations affecting our facilities could increase our operating costs, restrain our growth, limit us from taking advantage of opportunities presented and could have a material adverse effect on our business, financial condition and results of operations. Adverse changes in existing comprehensive zoning plans or zoning regulations that impose additional restrictions on the use or requirements with respect to our facilities may affect our ability to operate our existing facilities or acquire new facilities, which may adversely affect our results of operations and profitability.

We are subject to uncertainties regarding the impact of the Affordable Care Act and related payment reform efforts, which represent a significant change to the healthcare industry.

The Affordable Care Act provides for increased access to coverage for healthcare and seeks to reduce healthcare-related expenses. Overall, the expansion of health insurance coverage under the Affordable Care Act, most of which went into effect on January 1, 2014, is expected to be beneficial to the substance abuse treatment industry. Beginning January 1, 2014, health insurers are prohibited from denying coverage to individuals because of preexisting conditions. Further, all new small group and individual market health plans are required to cover ten essential health benefit categories, which include substance abuse addiction and mental health disorder services. Likewise, as of January 1, 2014, small group and individual market plans are required to comply with the requirements of the Mental Health Parity and Addiction Equity Act of 2008. According to HHS estimates published in February 2013, these changes are expected to expand coverage for substance abuse addiction treatment and mental health disorders treatment for another 62.5 million Americans.

The expansion of commercial insurance for substance abuse treatment services under the Affordable Care Act may result in a higher demand for services from all providers. This may bring new competitors to the market, some of which may be better capitalized and have greater market penetration than we do. Further, we expect increased demand for substance abuse treatment services to also increase the demand for case managers, therapists, medical technicians and others with clinical expertise in substance abuse treatment, which may make it both more difficult to adequately staff our substance abuse treatment facilities and could significantly increase our costs in delivering treatment, which may adversely affect both our operations and profitability.

 

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One of the many impacts of the Affordable Care Act has been a dramatic increase in payment reform efforts by federal and state government payors as well as commercial payors. These efforts take many forms including the growth of accountable care organizations (“ACOs”), pay-for-performance bonus arrangements, partial capitation arrangements and the bundling of services into a single payment. The end result of these efforts is that more risk of the overall cost of care is being transferred to providers. As institutional providers and their affiliated physicians assume more risk for the cost of care, we expect more services to be furnished within provider networks formed to accept these types of payment reform. Our ability to compete and retain our traditional sources of clients may be adversely affected by our exclusion from such networks or our inability to be included in such networks.

We cannot predict the impact the implementation of the Affordable Care Act and related rulemaking and regulations may have on our business, results of operations, cash flow, capital resources and liquidity or whether we will be able to adapt successfully to the changes required by the Affordable Care Act.

Change of ownership or change of control requirements imposed by state and federal licensure and certification agencies as well as third-party payors may limit our ability to timely realize opportunities, adversely affect our licenses and certifications, interrupt our cash flows and adversely affect our profitability.

State licensure laws and many federal healthcare programs (where applicable) impose a number of obligations on healthcare providers undergoing a change of ownership or change of control transaction. These requirements may require new license applications as well as notices given a fixed number of days prior to the closing of affected transactions. These provisions require us to be proactive when considering both internal restructuring, such as this offering and the Reorganization Transactions (as described in the section entitled “Prospectus Summary—Reorganization Transactions”), as well as acquisitions of third-party targets. Failure to provide such notices or to submit required paperwork can adversely affect licensure on a going forward basis, can subject the parties to penalties and can adversely affect our ability to operate our facilities.

Many third-party payor agreements, including government payor programs, also have change of ownership or change of control provisions. Such provisions generally include a prior notice provision as well as require the consent of the payor in order to continue the terms of the payor agreement. A failure to abide by the terms of such provisions can result in a breach of the underlying third-party payor agreement. Further, abiding by the terms of such provisions may reopen pricing negotiations with third-party payors where the provider currently has favorable reimbursement terms as compared to the market. Currently, we have very few third-party payor agreements; however, as substance abuse treatment coverage and payment reform initiatives continue to expand, these types of provisions could have a significant impact on our ability to realize opportunities as well as adversely affect our cash flows and profitability.

We could face risks associated with, or arising out of, environmental, health and safety laws and regulations.

We are subject to various federal, state and local laws and regulations that:

 

    regulate certain activities and operations that may have environmental or health and safety effects, such as the generation, handling and disposal of medical wastes;

 

    impose liability for costs of cleaning up, and damages to natural resources from, past spills, waste disposals on and off-site or other releases of hazardous materials or regulated substances; and

 

    regulate workplace safety.

Compliance with these laws and regulations could increase our costs of operation. Violation of these laws may subject us to significant fines, penalties or disposal costs, which could negatively impact our results of operations, financial position or cash flows. We could be responsible for the investigation and remediation of environmental conditions at currently or formerly operated or leased sites, as well as for associated liabilities, including liabilities for natural resource damages, third-party property damage or personal injury resulting from lawsuits that could be brought by the government or private litigants relating to our operations, the operations of

 

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our facilities or the land on which our facilities are located. We may be subject to these liabilities regardless of whether we lease or own the facility, and regardless of whether such environmental conditions were created by us or by a prior owner or tenant, or by a third-party or a neighboring facility whose operations may have affected such facility or land, because liability for contamination under certain environmental laws can be imposed on current or past owners or operators of a site without regard to fault. We cannot assure you that environmental conditions relating to our prior, existing or future sites or those of predecessor companies whose liabilities we may have assumed or acquired will not have a material adverse effect on our business.

State efforts to regulate the construction or expansion of healthcare facilities could impair our ability to operate and expand our facilities.

The construction of new healthcare facilities, the expansion of existing facilities, the transfer or change of ownership of existing facilities and the addition of new beds, services or equipment may be subject to state laws that require prior approval by state regulatory agencies under certificate of need laws. These laws generally require that a state agency determine the public need for construction or acquisition of facilities or the addition of new services. Review of certificates of need and other healthcare planning initiatives may be lengthy and may require public hearings. Violations of these state laws may result in the imposition of civil sanctions or revocation of a facility’s license. We currently do not operate facilities in any states where a certificate of need is required to be obtained for capital expenditures exceeding a prescribed amount, changes in capacity or services offered. States in which we now or may in the future operate may require certificates of need under certain circumstances not currently applicable to us or may impose standards and other health planning requirements upon us. Our failure to obtain any necessary state approval could:

 

    result in our inability to acquire a targeted facility, complete a desired expansion or make a desired replacement; or

 

    result in the revocation of a facility’s license or impose civil or criminal penalties on us,

any of which could have a material adverse effect on our business, financial condition and results of operations.

If we are unable to obtain required regulatory, zoning or other required approvals for renovations and expansions, our growth may be restrained and our operating results may be adversely affected. In the past, we have not experienced any material adverse effects from such requirements, but we cannot predict the future impact of these changes upon our operations.

Risks Related to Our Organization and Structure

We are a holding company with nominal net worth and will depend on dividends and distributions from our subsidiaries to pay dividends, if any.

AAC Holdings, Inc. is a holding company with nominal net worth. We do not have any assets or conduct any business operations other than our investments in our subsidiaries. Our business operations are conducted primarily out of our direct operating subsidiary, AAC. As a result, our ability to pay dividends, if any, will be dependent upon cash dividends and distributions or other transfers to us from our subsidiaries, including AAC. Payments to us by our subsidiaries will be contingent upon their respective earnings and subject to any limitations on the ability of such entities to make payments or other distributions to us. In addition, our subsidiaries, including our direct operating subsidiary, AAC, are separate and distinct legal entities and have no obligation to make any funds available to us.

 

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Our directors, executive officers and principal stockholders and their respective affiliates will continue to have substantial control over the company after this offering and could delay or prevent a change in corporate control.

After this offering, our directors, executive officers and holders of more than 5% of our common stock, together with their affiliates, will beneficially own, in the aggregate, approximately     % of our outstanding common stock. In addition, Michael T. Cartwright, our Chairman and Chief Executive Officer, and his affiliates will own approximately     % of our common stock, and Jerrod N. Menz, our President, and his affiliates will own approximately     % of our common stock. As a result, these stockholders, acting together, will continue to have substantial control over the outcome of matters submitted to our stockholders for approval, including the election of directors and any merger, consolidation or sale of all or substantially all of our assets. In addition, these stockholders, acting together, will continue to have significant influence over the management and affairs of our company. Accordingly, this concentration of ownership may have the effect of:

 

    delaying, deferring or preventing a change in corporate control;

 

    impeding a merger, consolidation, takeover or other business combination involving us; or

 

    discouraging a potential acquirer from making a tender offer or otherwise attempting to obtain control of us.

Anti-takeover provisions in our articles of incorporation, bylaws and Nevada law could prevent or delay a change in control of our company.

Provisions in our articles of incorporation and amended and restated bylaws, which we refer to as our bylaws, which bylaws will become effective upon the closing of this offering, may discourage, delay or prevent a merger, acquisition or change of control. These provisions could also discourage proxy contests and make it more difficult for stockholders to elect directors and take other corporate actions. These provisions:

 

    permit our Board of Directors to issue up to 5,000,000 shares of preferred stock, with any rights, preferences and privileges as they may designate, including the right to approve an acquisition or other change in our control;

 

    provide that the authorized number of directors may be changed only by resolution of the Board of Directors;

 

    provide that all vacancies, including newly created directorships, may, except as otherwise required by law, be filled by the affirmative vote of a majority of directors then in office, even if less than a quorum;

 

    provide that stockholders seeking to present proposals before a meeting of stockholders or to nominate candidates for election as directors at a meeting of stockholders must provide notice in writing in a timely manner and also specify requirements as to the form and content of a stockholder’s notice;

 

    provide that our stockholders may not take action by written consent, but may only take action at annual or special meetings of our stockholders;

 

    do not provide for cumulative voting rights (therefore allowing the holders of a majority of the shares of common stock entitled to vote in any election of directors to elect all of the directors standing for election, if they should so choose); and

 

    provide that special meetings of our stockholders may be called only by the chairman of the Board of Directors, our Chief Executive Officer, the Board of Directors pursuant to a resolution adopted by a majority of the total number of authorized directors or the holders of a majority of the outstanding shares of voting stock.

 

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We may be subject to additional risks and uncertainties as a result of the Reorganization Transactions, including risks related to whether a short-form merger is completed in a timely manner, or at all, following the completion of this offering.

Prior to this offering, Holdings engaged in a voluntary private share exchange with certain stockholders of AAC, whereby holders representing 93.6% of the outstanding shares of common stock of AAC exchanged their shares on a one-for-one basis for shares of Holdings common stock. We refer to this transaction as the Private Share Exchange. Subsequent to this offering, Holdings expects to conduct a subsidiary short-form merger with AAC whereby the legacy holders who did not participate in the Private Share Exchange would be entitled to receive Holdings shares on a one-for-one basis. We currently expect to register this short-form merger on a Form S-4 registration statement to be filed with the SEC after consummation of this offering. Consummation of the short-form merger may be delayed or prevented by a number of factors outside our control. If the short-form merger is not completed in a timely manner, or at all, a significant minority interest in AAC will be held by third parties, which may affect the manner in which we conduct our business.

The lack of public company experience of our management team could adversely impact our ability to comply with the reporting requirements of U.S. securities laws.

Our management team lacks public company experience, which could impair our ability to comply with legal and regulatory requirements such as those imposed by the SEC, the New York Stock Exchange, or the NYSE, or Sarbanes-Oxley, which would apply to us after this offering. In addition, prior to the completion of this offering, we have been a private company with limited accounting personnel and other related resources, and we have only recently hired accounting personnel with SEC reporting experience. Despite recent reforms made possible by the JOBS Act, compliance with the securities laws and regulations, as well as the requirements of the NYSE, will occupy a significant amount of time of our management and will significantly increase our legal, accounting and other expenses, particularly after we no longer qualify as an “emerging growth company.” Our senior management may not be able to implement programs and policies in an effective and timely manner that adequately respond to such increased legal, regulatory compliance and reporting requirements, including establishing and maintaining internal controls over financial reporting. Any such deficiencies, weaknesses or lack of compliance could have a material adverse effect on our ability to comply with the reporting requirements of the Securities Exchange Act of 1934, or the Exchange Act, which is necessary to maintain our public company status. If we were to fail to fulfill any of these public company reporting obligations, our ability to continue as a U.S. public company would be in jeopardy, in which event you could lose your entire investment in our company.

We are an emerging growth company, and we cannot be certain if the reduced reporting requirements applicable to emerging growth companies will make our common stock less attractive to investors.

We are an “emerging growth company” as defined under the JOBS Act. For as long as we continue to be an emerging growth company, we may take advantage of exemptions from various reporting requirements that are applicable to other public companies that are not emerging growth companies, including not being required to comply with the auditor attestation requirements of Section 404 of Sarbanes-Oxley, reduced disclosure obligations regarding executive compensation in our periodic reports and proxy statements and exemptions from the requirements of holding a nonbinding advisory vote on executive compensation and stockholder approval of any golden parachute payments not previously approved. We could be an emerging growth company for up to five years, although we could lose that status sooner if our revenues exceed $1 billion, if we issue more than $1 billion in non-convertible debt in a three year period or if the market value of our common stock held by non-affiliates meets or exceeds $700 million as of any June 30th before that time, in which case we would no longer be an emerging growth company as of the following December 31st. We cannot predict if investors will find our common stock less attractive because we may rely on these exemptions. If some investors find our common stock less attractive as a result, there may be a less active trading market for our common stock, and our stock price may be more volatile.

 

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Under the JOBS Act, emerging growth companies can also delay adopting new or revised accounting standards until such time as those standards apply to private companies. We have irrevocably elected not to avail ourselves of this extended transition period for implementing new or revised accounting standards and, therefore, will comply with new or revised accounting standards on the relevant dates on which adoption of such standards is required for other public companies that are not emerging growth companies.

Risks Related to this Offering

Market volatility may cause our stock price and the value of your investment to decline.

The initial public offering price for our common stock was determined through negotiations between the underwriters and us. The initial public offering price may vary from the market price of our common stock after the closing of this offering. Investors may not be able to sell their common stock at or above the initial public offering price.

We expect that the price of our common stock will fluctuate substantially as the market price for our common stock after this offering will be affected by a number of factors including:

 

    changes in policies affecting third-party coverage and reimbursement in the United States;

 

    our ability to achieve market success;

 

    actual or anticipated variations in our results of operations or those of our competitors;

 

    announcements of new services, innovations or product advancements by us or our competitors;

 

    sales of common stock or other securities by us or our stockholders in the future;

 

    additions or departures of key management personnel;

 

    trading volume of our common stock;

 

    developments in our industry; and

 

    general market conditions and other factors unrelated to our operating performance or the operating performance of our competitors.

In addition, the stock prices of many companies in the healthcare industry have experienced wide fluctuations that have often been unrelated to the operating performance of these companies. We expect our stock price to be similarly volatile. These broad market fluctuations may continue and could harm our stock price. Following periods of volatility in the market price of a company’s securities, stockholders have often instituted class action securities litigation against those companies. Class action securities litigation, if instituted against us, could result in substantial costs and a diversion of our management resources, which could have a material adverse effect on our business, financial condition and results of operations.

Securities analysts may not initiate coverage for our common stock or may issue negative reports, and this may have a negative impact on the market price of our common stock.

Securities analysts may elect not to provide research coverage of our common stock after the completion of this offering. The lack of research coverage may adversely affect the market price of our common stock. The trading market for our common stock may be affected in part by the research and reports that industry or financial analysts publish about us or our business, and our failure to achieve analyst earnings estimates. It may be difficult for companies such as ours, with smaller market capitalizations, to attract securities analysts that will cover our common stock. If one or more of the analysts who elects to cover us downgrades our stock, our stock price would likely decline rapidly. If one or more of these analysts ceases coverage of our company, we could lose visibility in the market, which in turn could cause our stock price to decline.

 

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We have not paid dividends in the past and do not expect to pay dividends in the future.

We have never declared or paid cash dividends on our common stock. We currently intend to retain all available funds and any future earnings to support our operations and finance the growth and development of our business, and therefore, we do not anticipate paying cash dividends in the foreseeable future. Any future determination related to the payment of dividends will be made at the discretion of our Board of Directors and will depend on, among other factors, our results of operations, financial condition, capital requirements, contractual restrictions, business prospects and other factors our Board of Directors may deem relevant. In addition, as a holding company, our ability to pay dividends, if any, will be dependent upon cash dividends and distributions or other transfers from our subsidiaries, including AAC. Payments to us by our subsidiaries will be contingent upon their respective earnings and subject to any limitations on the ability of such entities to make payments or other distributions to us. Our subsidiaries, including our direct operating subsidiary, AAC, are separate and distinct legal entities and have no obligation to make any funds available to us. Additionally, the terms of our Credit Facility impose restrictions on our ability to declare and pay dividends. If we do not pay dividends, a return on your investment will only occur if our stock price appreciates.

Sales of a substantial number of shares of our common stock in the public market after this offering, or the perception that they may occur, may depress the market price of our common stock.

Sales of substantial amounts of our common stock in the public market following this offering, or the perception that substantial sales may be made, could cause the market price of our common stock to decline. The lock-up agreements to be delivered by our executive officers, directors and certain of our stockholders provide that the underwriters, acting jointly and in their discretion, may release those parties, at any time, or from time to time, and without notice, from their obligation not to dispose of shares of common stock for a period of 180 days after the date of this prospectus. The underwriters do not have any pre-established conditions to waiving the terms of the lock-up agreements, and any decision by them to waive those conditions would depend on a number of factors, which may include market conditions, the performance of the common stock in the market and our financial condition at that time.

Based on the number of shares of common stock outstanding as of                     , 2014, upon completion of this offering,             shares of our common stock will be outstanding. All of the shares sold in this offering will be freely transferable unless held by an affiliate of ours. The lock-up agreements between the underwriters and our directors, executive officers and those stockholders participating in the Private Share Exchange and directed share program will expire 180 days after the date of this prospectus, at which time all of the shares of our common stock will be freely transferable subject to compliance with the provisions of Rule 144. See “Shares Eligible for Future Sale—Lock-up Agreements.” Our affiliates must comply with the volume, manner of sale, holding period and other limitations of Rule 144. As restrictions on resale end, the market price could drop significantly if the holders of these restricted shares sell them or are perceived by the market as intending to sell them. Any substantial sale of common stock pursuant to any resale registration statements or Rule 144 may have an adverse effect on the market price of our common stock by creating an excessive supply.

We intend to file a registration statement on Form S-8 to register the 1,000,000 shares reserved for issuance under our 2014 Equity Incentive Plan. The registration statement will become effective when filed, and, subject to applicable lock-up agreements, if any, these shares may be resold without restriction in the public marketplace. For a more detailed description, please see the section of this prospectus entitled “Shares Eligible for Future Sale—Equity Incentive Plans.”

We intend to file a registration statement on Form S-4 to register the 630,886 shares that we expect to issue pursuant to our short-form merger with AAC following the completion of this offering, whereby the legacy holders who did not participate in the Private Share Exchange would be entitled to receive Holdings shares on a one-for-one basis. When the registration statement is declared effective by the SEC, subject to applicable lock-up agreements, if any, these shares may be resold without restriction in the public marketplace. For a more detailed description, please see the section of this prospectus entitled “Shares Eligible for Future Sale—Short-Form Merger.”

 

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New investors in our common stock will experience immediate and substantial dilution after this offering.

If you purchase shares of our common stock in this offering, you will experience immediate dilution of $             per share, based on the mid-point of the range on the cover of this prospectus, because the price that you pay will be substantially greater than the adjusted pro forma net tangible book value per share of common stock that you acquire. This dilution is due in large part to the fact that many of our earlier investors paid substantially less than the price of the shares being sold in this offering when they purchased their shares of our capital stock. In addition, in the future we may decide to convert our operating company into a limited liability company and use common units in our operating company as currency to acquire facility properties, which could result in stockholder dilution or limit our ability to sell such properties, which could have a material adverse effect on us. See the section entitled “Dilution” in this prospectus for a more detailed description of this dilution.

An active trading market for our common stock may not develop.

Prior to this offering, there has been no public market for our common stock. Our common stock has been approved for listing on the NYSE; however, an active trading market for our shares may never develop or be sustained following this offering. Accordingly, you may not be able to sell your shares quickly or at the market price if trading in our stock is not active.

 

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SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS

We make statements in this prospectus that are forward-looking statements within the meaning of the federal securities laws. Some of the statements under “Prospectus Summary,” “Risk Factors,” “Use of Proceeds,” “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” “Business” and elsewhere in this prospectus may contain forward-looking statements that reflect our current views with respect to, among other things, future events and financial performance. Likewise, our pro forma financial statements and anticipated market conditions and results of operations are forward-looking statements. In some cases, you can identify forward-looking statements by terms such as “anticipates,” “believes,” “could,” “estimates,” “expects,” “may,” “potential,” “predicts,” “projects,” “should,” “will,” “would,” and similar expressions intended to identify forward-looking statements, although not all forward-looking statements contain these words. You can also identify forward-looking statements by discussions of strategy, plans or intentions. These statements involve known and unknown risks, uncertainties and other factors that may cause our actual results, levels of activity, performance or achievements to be materially different from the information expressed or implied by these forward-looking statements. These risks, uncertainties and other factors include, without limitation:

 

    our inability to operate certain key treatment facilities or our corporate office;

 

    our reliance on our sales and marketing program to continuously attract and enroll clients to our network of facilities;

 

    our dependence on payments by third-party payors with whom we are considered an “out-of-network” provider;

 

    the impact of an increase in uninsured and underinsured clients or the deterioration in the collectability of the accounts of such clients;

 

    a reduction in reimbursement rates by certain third-party payors that account for a significant portion of our revenues;

 

    our failure to successfully achieve growth through acquisitions and de novo expansions;

 

    the impact of governmental regulations on our operations and potential governmental investigations and claims or lawsuits or other claims brought against us by others;

 

    the impact of competition and its potential effect on census volume and the availability or cost of attracting and retaining talented medical support staff;

 

    our failure to obtain necessary outside financing on favorable terms or at all;

 

    our ability to meet our debt obligations and the impact of the restrictive covenants in our Credit Facility;

 

    our dependence on key management personnel;

 

    our failure to comply with extensive laws and government regulations impacting our industry;

 

    the impact of legislative and regulatory initiatives relating to privacy and security of client health information and standards for electronic transactions;

 

    the impact of recent healthcare reform;

 

    the impact of state efforts to regulate the construction or expansion of healthcare facilities on our ability to operate and expand our operations;

 

    the fact that our directors, executive officers and principal stockholders will continue to have substantial control over us after this offering;

 

    the fact that we have not previously been required to comply with regulatory requirements applicable to publicly-traded companies;

 

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    the impact of market volatility and the initiation or lack of security analyst coverage on the market price of our common stock;

 

    general economic conditions; and

 

    the other risks described under the heading “Risk Factors.”

The factors identified above should not be construed as an exhaustive list of factors that could affect our future results and should be read in conjunction with the other cautionary statements that are included in this prospectus. Although we believe that we have a reasonable basis for each forward-looking statement contained in this prospectus, we caution you that these statements are based on a combination of facts and factors currently known by us and our projections of the future about which we cannot be certain.

As a result of these factors, we cannot assure you that the forward-looking statements in this prospectus will prove to be accurate. Furthermore, if our forward-looking statements prove to be inaccurate, the inaccuracy may be material. In light of the significant uncertainties in these forward-looking statements, you should not regard these statements as a representation or warranty by us or any other person that we will achieve our objectives and plans in any specified time frame or at all. We do not undertake to update any of the forward-looking statements after the date of this prospectus except to the extent required by applicable securities laws.

 

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USE OF PROCEEDS

We estimate that the net proceeds from our issuance and sale of              shares of common stock in this offering will be approximately $         million, assuming an initial public offering price of $         per share (the midpoint of the price range set forth on the cover page of this prospectus) and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us. The principal reasons for this offering are to increase our available cash resources, increase awareness of our company in the marketplace and create a public market for our common stock.

A $1.00 increase or decrease in the assumed initial public offering price of $         per share would increase or decrease, as applicable, our expected net proceeds from this offering by approximately $         million, assuming that the number of shares offered by us, as set forth on the cover page of this prospectus, remains the same and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us.

If the underwriters exercise their over-allotment option in full, we estimate that the net proceeds from this offering will be approximately $         million, assuming an initial public offering price of $         per share (the midpoint of the price range set forth on the cover page of this prospectus) and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us.

We intend to use the net proceeds to repay approximately $         million of outstanding indebtedness, consisting of the outstanding balance of approximately $         million on our revolving line of credit and a term loan of approximately $1.7 million that we assumed and refinanced in connection with the BHR Acquisition. We intend to use the remaining approximately $         million of net proceeds for working capital and other general corporate purposes, which may include the financing of future potential acquisitions and de novo facility developments, although we have no current specific plans for the remaining portion of the net proceeds as of the date of this prospectus.

The amounts and timing of the use of the remaining approximately $         million of net proceeds not being used to repay existing indebtedness will vary depending on the amount of cash generated by our operations, competitive and industry developments, market opportunities and the rate of growth, if any, of our business. Accordingly, we will have significant discretion and flexibility in applying the remaining portion of the net proceeds. Pending the above uses, we plan to invest the remaining net proceeds that we receive in this offering in short-term and intermediate-term interest-bearing obligations, investment-grade investments, certificates of deposit or direct or guaranteed obligations of the U.S. government.

As of June 30, 2014, the interest rate on our revolving line of credit, which is available for general corporate purposes and matures on April 1, 2015, was 3.15%. As of June 30, 2014, the interest rate under the term loan, which matures on April 15, 2015, was 5.0%. The original proceeds from the term loan were used to repay a loan of a BHR subsidiary, Greenhouse Real Estate, LLC.

An affiliate of Wells Fargo Securities, LLC, an underwriter in this offering, is the lender under our Credit Facility and will receive more than 5% of the net proceeds from this offering. Accordingly, Wells Fargo Securities, LLC will be deemed to have a “conflict of interest” with us within the meaning of Rule 5121 of the Conduct Rules of FINRA. Accordingly, this offering will be made in compliance with the applicable provisions of Rules 5110 and 5121 of the Conduct Rules regarding the underwriting of securities of a company with a member that has a conflict of interest within the meaning of those rules. William Blair & Company, L.L.C. has agreed to serve as a “qualified independent underwriter” as defined by FINRA and performed due diligence investigations and reviewed and participated in the preparation of the registration statement of which this prospectus forms a part. Wells Fargo Securities, LLC will not execute sales in discretionary accounts without the prior written specific approval of its customers. For more information, see “Underwriting—Conflict of Interest.”

 

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DIVIDEND POLICY

We have never declared or paid cash dividends on our common stock. We currently intend to retain all available funds and any future earnings to support our operations and finance the growth and development of our business. We do not intend to pay cash dividends on our common stock for the foreseeable future. Any future determination related to dividend policy will be made at the discretion of our Board of Directors and will depend on, among other factors, our results of operations, financial condition, capital requirements, contractual restrictions, business prospects and other factors our Board of Directors may deem relevant. In addition, as a holding company, our ability to pay dividends, if any, will be dependent upon cash dividends and distributions or other transfers from our subsidiaries, including AAC. Payments to us by our subsidiaries will be contingent upon their respective earnings and subject to any limitations on the ability of such entities to make payments or other distributions to us. Our subsidiaries, including our direct operating subsidiary, AAC, are separate and distinct legal entities and have no obligation to make any funds available to us. Additionally, the terms of our Credit Facility impose restrictions on our ability to declare and pay dividends. If we do not pay dividends, a return on your investment will only occur if our stock price appreciates.

 

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CAPITALIZATION

The following table sets forth our consolidated cash and cash equivalents and capitalization as of June 30, 2014:

 

    on an actual basis; and

 

    on a pro forma as adjusted basis to give effect to the sale of             shares of our common stock in this offering by us at an assumed initial public offering price of $             per share (the midpoint of the price range set forth on the cover page of this prospectus) and the application of the net proceeds from this offering, after deducting the underwriting discounts and commissions and estimated offering expenses payable by us, to repay approximately $             million of outstanding indebtedness.

You should read the following table in conjunction with the sections entitled “Use of Proceeds,” “Selected Historical and Pro Forma Consolidated Financial and Operating Data” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and our consolidated financial statements and related notes included elsewhere in this prospectus.

 

     As of June 30, 2014  
     Actual
(unaudited)
     Pro Forma
as Adjusted (1)
 
     (amounts in thousands, except share and per
share data)
 

Cash and cash equivalents

   $ 2,382       $                
  

 

 

    

 

 

 

Debt, including current portion:

     

Real estate debt

   $ 26,752       $     

Subordinated notes payable (non-related party)

     697      

Other non-related party debt

     2,128      

Related party debt

     4,167      

Revolving line of credit

     13,050      
  

 

 

    

 

 

 

Total long term debt, including current portion

     46,794      
  

 

 

    

 

 

 

Total mezzanine equity (including noncontrolling interest) (2)

     7,835      
  

 

 

    

 

 

 

Stockholders’ equity (including noncontrolling interest):

     

AAC Holdings, Inc. common stock, $0.001 par value per share, 70,000,000 shares authorized, 9,975,885 shares issued and outstanding, actual; and              shares issued and outstanding, pro forma as adjusted

     10      

AAC Holdings, Inc. common stock subscribed, net of subscription receivable of $8

     92      

Additional paid-in capital

     22,413      

Retained earnings

     3,893      

Noncontrolling interest (3)

     89      
  

 

 

    

 

 

 

Total stockholders’ equity (including noncontrolling interest)

     26,497      
  

 

 

    

 

 

 

Total capitalization

   $ 83,508       $     
  

 

 

    

 

 

 

 

(1) A $1.00 increase or decrease in the assumed initial public offering price of $     per share, the midpoint of the price range set forth on the cover page of this prospectus, would increase or decrease, as applicable, our cash and cash equivalents and total stockholders’ equity by approximately $     million, assuming the number of shares offered by us, as set forth on the cover of this prospectus, remains the same and after deducting the underwriting discounts and commissions and estimated offering expenses payable by us.

(2) The actual column for total mezzanine equity includes 37,174 shares of AAC common stock that were not exchanged for shares of Holdings common stock and are classified as noncontrolling interest within mezzanine equity. For additional discussion of mezzanine equity, see Note 11 to our audited financial statements included elsewhere in this prospectus.

(3) Noncontrolling interest represents the equity of the Professional Groups (as defined in “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Consolidation of VIEs”) that we do not own as well as 593,712 shares of AAC common stock that were not exchanged for shares of Holdings common stock and are classified in permanent equity.

 

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DILUTION

If you invest in our common stock in this offering, your ownership interest will be diluted to the extent of the difference between the initial public offering price per share and the pro forma as adjusted net tangible book value per share of our common stock after this offering.

Our historical net tangible book value of our common stock as of June 30, 2014 was $8.7 million, or $0.87 per share, based on the 9,975,885 shares of common stock issued and outstanding as of June 30, 2014. Historical net tangible book value per share is determined by dividing the number of shares of common stock outstanding as of June 30, 2014 into our total net tangible assets (total assets less intangible assets) less total liabilities and noncontrolling interest.

Investors participating in this offering will incur immediate, substantial dilution. After giving effect to the sale of common stock offered by us in this offering at an assumed initial public offering price of $             per share (the midpoint of the price range set forth on the cover page of this prospectus), and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us, our as adjusted net tangible book value as of June 30, 2014 would have been approximately $             million, or approximately $             per share of common stock. This represents an immediate increase in as adjusted net tangible book value of $             per share to existing stockholders, and an immediate dilution of $             per share to investors participating in this offering.

The following table illustrates this per share dilution to investors participating in this offering:

 

Assumed initial public offering price per share

   $     

Historical net tangible book value per share as of June 30, 2014

     0.87   

Increase in pro forma as adjusted net tangible book value per share attributable to this offering

  

Pro forma as adjusted net tangible book value per share after this offering

  
  

 

 

 

Dilution per share to new investors in this offering

   $     
  

 

 

 

A $1.00 increase or decrease in the assumed initial public offering price of $             per share (the midpoint of the price range set forth on the cover page of this prospectus) would increase or decrease, as applicable, our as adjusted net tangible book value per share after this offering by $             and the dilution in pro forma as adjusted net tangible book value to investors participating in this offering by $             per share, assuming the number of shares offered by us, as set forth on the cover page of this prospectus, remains the same and after deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us.

If the underwriters exercise their over-allotment option in full to purchase              additional shares of common stock in this offering, our as adjusted net tangible book value per share after this offering would be $             per share, the increase in the net tangible book value per share to existing stockholders would be $             per share and the dilution to investors participating in this offering would be $             per share.

 

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The following table summarizes, as of June 30, 2014, the differences between the number of shares of common stock purchased from us by officers, directors and affiliated persons during the past five years (“Existing Stockholders”) and by new investors participating in this offering, the total consideration and the average price per share paid to us by Existing Stockholders and by investors participating in this offering, before deducting the estimated underwriting discounts and commissions and estimated offering expenses payable by us, at an assumed initial public offering price of $             per share (the midpoint of the price range set forth on the cover page of this prospectus):

 

     Shares Purchased     Total
Consideration
    Average Price
Per Share
 
     Number    Percent     Amount      Percent    

Existing Stockholders

               $                             $                

New Investors

            
  

 

  

 

 

   

 

 

    

 

 

   

 

 

 

Total

        100.0   $           100.0   $     
  

 

  

 

 

   

 

 

    

 

 

   

 

 

 

A $1.00 increase or decrease in the assumed initial public offering price of $             per share (the midpoint of the price range set forth on the cover page of this prospectus) would increase or decrease, as applicable, total consideration paid to us by investors participating in this offering by approximately $             million, assuming the number of shares offered by us, as set forth on the cover page of this prospectus, remains the same and after deducting estimated underwriting discounts and commissions and estimated offering expenses payable by us.

Except as otherwise indicated, the discussion and tables above assume no exercise of the underwriters’ over-allotment option. If the underwriters’ over-allotment option is exercised in full, the number of shares of common stock held by Existing Stockholders will be reduced to     % of the total number of shares of common stock to be outstanding after this offering, and the number of shares of common stock held by investors participating in this offering will be further increased to             , or     % of the total number of shares of common stock to be outstanding after this offering.

The number of shares in the table above excludes, as of June 30, 2014, 1,000,000 shares of common stock reserved for future issuance under our 2014 Equity Incentive Plan, which we have adopted in connection with this offering, and 630,886 shares of common stock that we plan to issue in connection with the subsidiary short-form merger with AAC subsequent to this offering.

We may choose to raise additional capital through the sale of equity or convertible debt securities due to market conditions or strategic considerations even if we believe we have sufficient funds for our current or future operating plans. To the extent that new options are issued under our equity incentive plans or we issue additional shares of common stock, other equity securities or convertible debt securities in the future, there will be further dilution to investors participating in this offering.

 

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UNAUDITED PRO FORMA CONSOLIDATED FINANCIAL STATEMENTS

Holdings was formed in the first quarter of 2014 and completed the Reorganization Transactions in April 2014, which included the Private Share Exchange, the BHR Acquisition and the CRMS Acquisition. As a result of the Reorganization Transactions, Holdings now owns (i) 93.6% of the outstanding common stock of AAC, (ii) 100% of the outstanding common membership interests in BHR, which represents 100% of the voting rights in BHR, and (iii) 100% of the outstanding membership interests in CRMS. To help fund or facilitate the Reorganization Transactions, the following additional financing transactions were undertaken in 2014 prior to or in connection with the Reorganization Transactions: (i) AAC sold 471,843 shares of its common stock in a private placement to certain accredited investors from February 2014 through April 2014, with net proceeds of $6.0 million, (ii) BHR sold 8.5 Series A Preferred Units to certain accredited investors in January and February 2014 with net proceeds of $0.4 million, (iii) BHR redeemed all of the outstanding 36.5 Series A Preferred Units from certain accredited investors in April 2014 and (iv) BHR sold 160 new Series A Preferred Units to an accredited investor in April 2014 with net proceeds of $7.8 million. The Reorganization Transactions and the financing transactions that occurred through June 2014 are reflected in our consolidated financial statements as of and for the six months ended June 30, 2014 and are reflected as pro forma adjustments in the unaudited pro forma consolidated statement of income for the year ended December 31, 2013. For additional information related to the Reorganization Transactions, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and Note 3 to our unaudited condensed consolidated financial statements included elsewhere in this prospectus.

The following unaudited pro forma consolidated balance sheet as of June 30, 2014 gives effect to this offering and the application of the net proceeds therefrom to repay approximately $             million of outstanding indebtedness as if each had been consummated on June 30, 2014. The following unaudited pro forma consolidated statement of income for the year ended December 31, 2013 gives effect to (i) the consolidation of Greenhouse Real Estate, LLC, (ii) the Reorganization Transactions and the financing transactions related to the Reorganization Transactions and (iii) this offering and our intended use of proceeds therefrom described in “Use of Proceeds,” as if each had been consummated on January 1, 2013. It does not include (i) any adjustments for Concorde Real Estate, LLC, a subsidiary of BHR, as its results of operations are included in the historical financial results for the entire year, (ii) any adjustments for The Academy Real Estate, LLC, a subsidiary of BHR, as its results of operations are included in the historical financial results for the entire period of existence during 2013 and (iii) the effect of the acquisition of the membership interests in CRMS prior to the April 15, 2014 acquisition date as CRMS does not meet the definition of a business under applicable regulations. The following unaudited pro forma condensed consolidated statement of income for the six months ended June 30, 2014 also gives effect to the (i) Reorganization Transactions and the financing transactions related to the Reorganization Transactions and (ii) this offering and our intended use of proceeds therefrom described in “Use of Proceeds,” as if each had been consummated on January 1, 2013. It does not include (i) any adjustments for Greenhouse Real Estate, LLC, Concorde Real Estate, LLC and The Academy Real Estate, LLC, each of which is a subsidiary of BHR, as their results of operations are included in the historical financial results for the entire six months and (ii) the effect of the acquisition of the membership interests of CRMS as CRMS does not meet the definition of a business under applicable regulations. The notes to the unaudited pro forma consolidated financial statements describe the pro forma amounts and adjustments presented.

The pro forma adjustments reflecting the completion of the BHR Acquisition are based upon accounting for the acquisition of BHR as an acquisition of additional ownership interests in a variable interest entity that does not result in a change of control of that subsidiary, as BHR was already being consolidated as a variable interest entity in accordance with ASC 810 (Consolidation) and upon the assumptions set forth in the notes included in this section. These unaudited pro forma consolidated financial statements should be read in conjunction with the accompanying notes. The pro forma statements are primarily based on, and should also be read in conjunction with, (i) AAC’s consolidated financial statements and accompanying notes as of and for the year ended December 31, 2013, (ii) our unaudited condensed consolidated financial statements and accompanying notes as of and for the six months ended June 30, 2014 and (iii) Greenhouse Real Estate, LLC’s Historical Statement of Revenues and Certain Direct Operating Expenses for the period from January 1, 2013 to October 7, 2013, all of which are included elsewhere in this prospectus.

 

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The unaudited pro forma consolidated financial statements are presented for informational purposes only and do not reflect future events that may occur after the foregoing transactions or any operating efficiencies or inefficiencies that may result from the transactions. Therefore, the unaudited pro forma consolidated financial statements are not necessarily indicative of results that would have been achieved had the businesses been consolidated during the period presented or the results that we will experience after the transactions are consummated. In addition, the preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. These estimates and assumptions are preliminary and have been made solely for purposes of developing these unaudited pro forma consolidated financial statements. Actual results could differ, perhaps materially, from these estimates and assumptions.

 

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UNAUDITED PRO FORMA CONSOLIDATED STATEMENT OF INCOME

FOR THE YEAR ENDED DECEMBER 31, 2013

 

    American
Addiction
 Centers, Inc. 
     Greenhouse 
Real Estate,
LLC for the
Period
January 1,
2013 to
October 7,
2013
    Pro Forma
 Adjustments 
        Pro Forma         This
 Offering 
        AAC
 Holdings, Inc. 
Pro Forma as
Adjusted
 
    (in thousands, except share and per share amounts)  

Income Statement Data:

                 

Revenues

  $ 115,741      $ 1,265      $ (1,265   (a)   $ 115,741        $                     $     

Operating expenses:

                 

Salaries, wages and benefits

    46,856                        46,856           

Advertising and marketing

    13,493                        13,493           

Professional fees

    10,277        13                 10,290           

Client related services

    7,986                        7,986           

Other operating expenses

    11,615                        11,615           

Rentals and leases

    4,634               (1,265   (a)     3,369           

Provision for doubtful accounts

    10,950                        10,950           

Litigation settlement

    2,588                        2,588           

Restructuring

    806                        806           

Depreciation and amortization

    3,003        125        65      (b)     3,193           
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Total operating expenses

    112,208        138        (1,200       111,146           
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Income (loss) from operations

    3,533        1,127        (65       4,595           

Interest expense

    1,390        388        87      (c)     1,865          (j)  
                (k)  

Other expense, net

    36                        36           
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Income (loss) before income tax expense

    2,107        739        (152       2,694           

Income tax expense

    615               211      (d)     1,325          (l)  
        499      (e)          
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Net income (loss)

    1,492        739        (862       1,369           

Less: net (income) loss attributable to noncontrolling interest

    (706     (739     2,093      (f)     563           
        (85   (g)          
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Net income attributable to American Addiction Centers, Inc.

    786               1,146          1,932           

Deemed contribution – redemption of Series B Preferred Stock

    1,000                        1,000           

Less: BHR Series A Preferred Unit dividend

                  (960   (h)     (960        
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Net income available to American Addiction Centers, Inc. common stockholders

  $ 1,786      $      $ 186        $ 1,972        $          $     
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Earnings per share:

                 

Basic

  $ 0.20      $      $        $ 0.21        $          $                    
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Diluted

  $ 0.20      $      $        $ 0.21        $          $     
 

 

 

   

 

 

   

 

 

     

 

 

     

 

 

     

 

 

 

Weighted-average shares outstanding:

                 

Basic

    8,819,062               357,617      (i)     9,176,679          (m)  

Diluted

    9,096,660               357,617      (i)     9,454,277          (m)  

See accompanying notes to unaudited pro forma consolidated financial statements.

 

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UNAUDITED PRO FORMA CONSOLIDATED STATEMENT OF INCOME

FOR THE SIX MONTHS ENDED JUNE 30, 2014

 

    AAC
Holdings,
Inc.
    Pro Forma
Adjustments
          Pro
Forma
    This
Offering
          AAC
Holdings, Inc.
Pro Forma as
Adjusted
 
    (in thousands, except share and per share amounts)  

Income Statement Data:

             

Revenues

  $ 59,203               $ 59,203      $                     $                

Operating expenses:

             

Salaries, wages and benefits

    24,124                 24,124         

Advertising and marketing

    7,079                 7,079         

Professional fees

    4,895                 4,895         

Client related services

    5,211                 5,211         

Other operating expenses

    5,551                 5,551         

Rentals and leases

    940                 940         

Provision for doubtful accounts

    6,288                 6,288         

Litigation settlement

    240                 240         

Depreciation and amortization

    2,228                 2,228         
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Total operating expenses

    56,556                 56,556         
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Income from operations

    2,647                 2,647         

Interest expense

    705                 705          (g  
              (h  

Other expense, net

    15                 15         
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Income before income tax expense

    1,927                 1,927         

Income tax expense (benefit)

    859        (23     (a     961          (i  
      125        (b        
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Net income

    1,068        102          966         

Less: net (income) loss attributable to noncontrolling interest

    668        346        (c )       949         
      (65     (d        
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Net income attributable to AAC Holdings, Inc. stockholders

    1,736        179          1,915         

Less: BHR Series A Preferred Unit dividend

    (203     (277     (e     (480      
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Net income available to AAC Holdings, Inc. common stockholders

  $ 1,533      $ (98     $ 1,435      $          $     
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Earnings per share:

             

Basic

  $ 0.16      $        $ 0.15      $          $                
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Diluted

  $ 0.16      $        $ 0.15      $          $                
 

 

 

   

 

 

     

 

 

   

 

 

     

 

 

 

Weighted-average shares outstanding:

             

Basic

    9,510,427        252,149        (f     9,762,576          (j  

Diluted

    9,544,420        252,149        (f     9,796,569          (j  

See accompanying notes to unaudited pro forma consolidated financial statements.

 

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UNAUDITED PRO FORMA CONSOLIDATED BALANCE SHEET

AS OF JUNE 30, 2014

 

     AAC
Holdings,
Inc.
     This
Offering
    AAC
Holdings, Inc.
Pro Forma as
Adjusted
 
     (in thousands)   

Assets

  

Current assets:

       

Cash and cash equivalents

   $ 2,382       $              (aa)    $                

Accounts receivable, net of allowances

     26,635        

Notes and other receivables—related party

     488        

Prepaid expenses and other current assets

     3,375        
  

 

 

    

 

 

   

 

 

 

Total current assets

     32,880        

Property and equipment, net

     44,311        

Goodwill

     12,702        

Intangible assets, net

     3,209        

Other assets

     650        
  

 

 

    

 

 

   

 

 

 

Total assets

   $ 93,752       $        $     
  

 

 

    

 

 

   

 

 

 

Liabilities, mezzanine equity and stockholders’ equity

       

Current liabilities:

       

Accounts payable

   $ 2,853       $        $     

Accrued liabilities

     8,086        

Current portion of deferred tax liabilities

     15        

Current portion of long-term debt

     17,406        

Current portion of long-term debt—related party

     791        
  

 

 

    

 

 

   

 

 

 

Total current liabilities

     29,151        

Deferred tax liabilities

     1,585        

Long-term debt, net of current portion

     25,221        

Long-term debt—related party, net of current portion

     3,376        

Other long-term liabilities

     87        
  

 

 

    

 

 

   

 

 

 

Total liabilities

     59,420        

Mezzanine equity including noncontrolling interest

       

Noncontrolling interest—American Addiction Centers, Inc. common stock

     53        

Noncontrolling interest—BHR Series A Preferred Units

     7,782        
  

 

 

    

 

 

   

 

 

 

Total mezzanine equity including noncontrolling interest

     7,835        

Stockholders’ equity including noncontrolling interest

       

Common stock AAC Holdings, Inc.

     10                  (aa)   

Common stock subscribed, net of subscription receivable AAC Holdings, Inc.

     92        

Additional paid-in capital

     22,413                  (aa)   

Retained earnings

     3,893        

Noncontrolling interest

     89        
  

 

 

    

 

 

   

 

 

 

Total stockholders’ equity including noncontrolling interest

     26,497        
  

 

 

    

 

 

   

 

 

 

Total liabilities, mezzanine equity and stockholders equity

   $ 93,752       $        $     
  

 

 

    

 

 

   

 

 

 

See accompanying notes to unaudited pro forma consolidated financial statements.

 

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NOTES TO THE UNAUDITED PRO FORMA CONSOLIDATED FINANCIAL STATEMENTS

The unaudited pro forma consolidated statement of income and unaudited pro forma consolidated balance sheet do not include any adjustments for the following:

 

    Concorde Real Estate, LLC, a subsidiary of BHR, as its results of operations are included in the historical financial results for the entire year as it has been consolidated as a variable interest entity (“VIE”) since June 27, 2012.

 

    The Academy Real Estate, LLC, a subsidiary of BHR, as its results of operations are included in the historical financial results for the entire period of its existence during 2013.

 

    The effects of the CRMS Acquisition as CRMS’s only revenue stream is with AAC and upon completion of the acquisition CRMS will no longer have revenues. Accordingly, CRMS does not meet the definition of a business under Regulation S-X Rule 11-01(d).

Additionally, Greenhouse Real Estate, LLC, a subsidiary of BHR, is not included in the historical balance sheet as of June 30, 2014 and in the historical results of operations for the six months ended June 30, 2014 as we have consolidated it as an VIE since October 8, 2013.

Note 1—Unaudited Pro Forma Consolidated Statement of Income Adjustments for the Year Ended December 31, 2013

The unaudited pro forma consolidated statement of income for the year ended December 31, 2013 gives effect to the adjustments described below relating to the initial VIE consolidation of Greenhouse Real Estate, LLC, a subsidiary of BHR, accounted for as a business combination, and the Reorganization Transactions, the financing transactions related to the Reorganization Transactions and this offering and the use of proceeds therefrom as described in “Use of Proceeds,” as if each had been consummated on January 1, 2013.

 

  (a) Reflects the elimination of historical rental revenues received by Greenhouse Real Estate, LLC and paid by the Company.

 

  (b) Reflects additional depreciation expense for the period from January 1 to October 7, 2013 attributable to recording the assets of Greenhouse Real Estate, LLC at fair value on October 8, 2013, the date on which Greenhouse Real Estate, LLC became a consolidated VIE.

 

  (c) Reflects additional interest expense related to the $1.8 million term loan, which bears interest at 5.0% per annum, assumed and refinanced by us in connection with the BHR Acquisition from the individuals who collectively owned 100% of the common membership interests of BHR prior to the BHR Acquisition. Our Credit Facility requires us to repay this loan in full with proceeds from this offering (see adjustment (j) below).

 

  (d) Reflects the estimated income tax expense, at an effective income tax rate of 36.0%, on (i) Greenhouse Real Estate, LLC income for the period from January 1, 2013 through October 7, 2013, (ii) the pro forma adjustments related to Greenhouse Real Estate, LLC for the period from January 1, 2013 through October 7, 2013 as set forth in adjustments (a) through (c) above and (iii) the pro forma adjustment related to the income attributable to shares of AAC common stock that were not exchanged for shares of Holdings common stock in the Private Share Exchange and classified in mezzanine equity. The historical results of Greenhouse Real Estate, LLC do not include a provision for income tax expense as the LLC is a flow-through entity for tax purposes and AAC was not a member of the LLC.

 

  (e) Reflects the estimated income tax expense, at an income tax rate of 36.0%, on $1.4 million of net income of the BHR subsidiaries included in the historical results of AAC. The historical results of BHR do not include a provision for income tax expense as BHR is a flow-through entity for tax purposes and AAC was not a member of BHR.

 

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  (f) Reflects the elimination of the noncontrolling interest as a result of the BHR Acquisition. The Series A Preferred Unit holder does not have any rights to the income of BHR other than the payment of the 12% per annum preferred return. The net loss (income) attributable to noncontrolling interest in the “Pro Forma” column represents the net loss of the professional groups with which our treatment facilities have management services arrangements. For additional information related to these professional groups, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Consolidation of VIEs” included elsewhere in this prospectus.

 

  (g) Reflects the income attributable to shares of AAC common stock that were not exchanged for Holdings common stock and classified in mezzanine equity.

 

  (h) Reflects the $960,000 dividend with respect to the 12% per annum preferred return on the outstanding Series A Preferred Units that were issued by BHR on April 15, 2014 to BNY Alcentra Group Holdings, Inc.

 

  (i) Reflects (i) the sale of 471,843 shares of AAC common stock to certain accredited investors from February through April 2014, (ii) the issuance of 521,999 shares of Holdings common stock in connection with the BHR Acquisition and (iii) the deduction of the 636,225 shares of AAC common stock not exchanged for Holdings shares in the Private Share Exchange as discussed in Note 3 to the unaudited condensed consolidated financial statements.

 

  (j) Reflects the elimination of the historical interest expense on our Credit Facility for 2013. The outstanding balance of the revolving line will be paid down with proceeds from this offering.

 

  (k) Reflects the elimination of the pro forma interest expense on the $1.8 million term loan with a financial institution assumed in connection with the BHR Acquisition that will be repaid in full with proceeds from this offering.

 

  (l) Reflects the estimated tax impact of the elimination of interest expense as described in (j) and (k) above.

 

  (m) Reflects the sale of              shares of Holdings common stock in connection with this offering.

Note 2—Unaudited Pro Forma Consolidated Statement of Income Adjustments for the Six Months Ended June 30, 2014

The unaudited pro forma consolidated statement of income for the six months ended June 30, 2014 gives effect to the adjustments described below relating to the Reorganization Transactions, the financing transactions related to the Reorganization Transactions and this offering and the use of proceeds therefrom as described in “Use of Proceeds,” as if each had been consummated on January 1, 2013.

 

  (a) Reflects the estimated income tax benefit, at an effective income tax rate of 36.0%, on the pro forma adjustment related to the income attributable to shares of AAC common stock that were not exchanged for shares of Holdings common stock in the Private Share Exchange and classified in mezzanine equity.

 

  (b) Reflects the estimated income tax expense, at an income tax rate of 36.0%, on $0.3 million of net income of the BHR subsidiaries included in the historical results of AAC. The historical results of BHR do not include a provision for income tax expense as BHR is a flow-through entity for tax purposes and AAC was not a member of BHR prior to the BHR Acquisition.

 

  (c)

Reflects the elimination of the noncontrolling interest as a result of the BHR Acquisition. The Series A Preferred Unit holder does not have any rights to the income of BHR other than the payment of the 12% per annum preferred return. The net loss (income) attributable to noncontrolling interest in the “Pro Forma” and “AAC Holdings, Inc. Pro Forma as Adjusted” columns represent the net loss of the professional groups with which our treatment facilities have management services arrangements. For additional information related to these pro-

 

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  fessional groups, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Consolidation of VIEs” included elsewhere in this prospectus.

 

  (d) Reflects the income attributable to the shares of AAC common stock that were not exchanged for shares of Holdings common stock in the Private Share Exchange and classified in mezzanine equity.

 

  (e) Reflects the $480,000 dividend for the six months ended June 30, 2014 with respect to the 12% per annum preferred return on the outstanding Series A Preferred Units that were issued by BHR on April 15, 2014 to BNY Alcentra Group Holdings, Inc.

 

  (f) Reflects (i) the addition of 82,176 shares of common stock to fully reflect the sale of 143,017 shares of AAC common stock to certain accredited investors in April 2014 as outstanding for the entire six months ended June 30, 2014 (60,841 shares were included in the historical column of the weighted-average shares outstanding), (ii) the addition of 105,510 shares of common stock to fully reflect the 328,826 shares of AAC common stock sold to certain accredited investors in February and March 2014 as outstanding for the entire six months ended June 30, 2014 (223,316 shares were included in the historical column of the weighted-average shares outstanding), (iii) the addition of 299,933 shares of common stock to fully reflect the issuance of 521,999 shares of common stock in connection with the BHR Acquisition as outstanding for the entire six months ended June 30, 2014 (222,066 shares were included in the historical column of the weighted-average shares outstanding) and (iv) the deduction of 235,470 shares of common stock to fully reflect the deduction of the 636,225 shares of AAC common stock not exchanged for Holdings shares in the Private Share Exchange as discussed in Note 3 to the unaudited condensed consolidated financial statements (400,755 shares were deducted in the historical column of the weighted-average shares outstanding).

 

  (g) Reflects the elimination of the historical interest expense on our Credit Facility for 2014. The outstanding balance of the revolving line will be paid down with proceeds from this offering.

 

  (h) Reflects the elimination of the pro forma interest expense on the $1.8 million term loan with a financial institution assumed in connection with the BHR Acquisition that will be repaid in full with proceeds from this offering.

 

  (i) Reflects the estimated tax impact of the elimination of interest expense as described in (g) and (h) above.

 

  (j) Reflects the sale of              shares of Holdings common stock in connection with this offering.

Note 3—Unaudited Pro Forma Consolidated Balance Sheet Adjustment as of June 30, 2014

The unaudited pro forma consolidated balance sheet as of June 30, 2014 gives effect to this offering and our intended use of proceeds therefrom as described in “Use of Proceeds” as if each had occurred on June 30, 2014:

 

  (aa) Reflects the issuance of             shares of Holdings common stock at the initial public offering price of $         per share (the midpoint of the price range set forth on the cover page of this prospectus) and the estimated net proceeds of $         and a use of a portion of the proceeds to repay $         million of outstanding indebtedness. The recording of the proceeds also reflects the reclassification of offering expenses of $         out of prepaid and other current assets.

 

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SELECTED HISTORICAL AND PRO FORMA CONSOLIDATED

FINANCIAL AND OPERATING DATA

The following tables present our selected historical and pro forma consolidated financial and operating data as of the dates and for the periods indicated. Holdings was formed as a Nevada corporation on February 12, 2014, and acquired 93.6% of the outstanding shares of common stock of AAC on April 15, 2014 in connection with the Reorganization Transactions, and Holdings therefore controls AAC. Prior to the completion of the Reorganization Transactions, Holdings had not engaged in any business or other activities except in connection with its formation. Accordingly, all financial and operating data herein relating to periods prior to the completion of the Reorganization Transactions is that of AAC and its consolidated subsidiaries and is referred to herein as “our” historical financial and operating data.

The selected consolidated financial data as of and for the years ended December 31, 2012 and 2013 are derived from our audited consolidated financial statements included elsewhere in this prospectus. The selected consolidated financial data for the year ended December 31, 2011 are derived from our audited consolidated financial statements not included in this prospectus. The selected consolidated financial data as of June 30, 2014 and for the six months ended June 30, 2013 and 2014 are derived from our unaudited condensed consolidated financial statements included elsewhere in this prospectus. The following selected consolidated financial data should be read together with our audited consolidated financial statements, unaudited condensed consolidated financial statements and accompanying notes and information under the caption “Management’s Discussion and Analysis of Financial Condition and Results of Operations” included elsewhere in this prospectus. The selected consolidated financial data in this section are not intended to replace our consolidated financial statements and the related notes. In the opinion of management, the interim financial data set forth below include all adjustments, consisting of normal recurring accruals, necessary to fairly present our financial position. Our historical results are not necessarily indicative of results that may be expected in the future. See Note 3 to our unaudited condensed consolidated financial statements included elsewhere in this prospectus for additional information regarding the BHR Acquisition and the CRMS Acquisition and see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” for a discussion of the anticipated impact the BHR Acquisition and the CRMS Acquisition will have on our future results of operations and financial position.

The selected unaudited pro forma financial and other data for the year ended December 31, 2013 and as of and for the six months ended June 30, 2014 have been adjusted to give effect to this offering and our intended use of proceeds from this offering and, in the case of the unaudited pro forma consolidated income statement data, certain other transactions as described in the section titled “Unaudited Pro Forma Consolidated Financial Statements” included elsewhere in this prospectus. Specifically, the “Pro Forma as Adjusted” columns in the selected unaudited pro forma consolidated income statement and other data give effect to the Reorganization Transactions, the related financing transactions and this offering and our intended use of proceeds therefrom as described in “Use of Proceeds,” in each case for the year ended December 31, 2013 and for the six months ended June 30, 2014. This data is subject and gives effect to the assumptions and adjustments described in the notes accompanying the unaudited pro forma consolidated financial statements included elsewhere in this prospectus. The selected unaudited pro forma financial data is presented for informational purposes only and should not be considered indicative of actual results of operations that would have been achieved had the transactions and this offering been consummated on the dates indicated, and does not purport to be indicative of financial condition data or results of operations as of any future date or for any future period.

 

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                Year Ended
December 31, 2013
    Six Months
Ended

June 30,
        2013        

Actual
(unaudited)
    Six Months Ended
June 30, 2014
 
    Year Ended December 31,           Pro Forma
as Adjusted
      Actual
(unaudited)
    Pro Forma
as Adjusted
 
            2011                     2012             Actual          
    (in thousands, except for share and per share amounts)  

Income Statement Data:

             

Revenues

  $ 28,275      $ 66,035      $ 115,741      $                   $ 59,331      $ 59,203      $                
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating expenses:

             

Salaries, wages and benefits

    9,171        25,680        46,856          21,732        24,124     

Advertising and marketing

    4,915        8,667        13,493          6,588        7,079     

Professional fees

    1,636        5,430        10,277          4,706        4,895     

Client related services

    5,791        8,389        7,986          3,567        5,211     

Other operating expenses

    2,448        6,384        11,615          6,213        5,551     

Rentals and leases

    1,196        3,614        4,634          2,772        940     

Provision for doubtful accounts

    1,063        3,344        10,950          4,820        6,288     

Litigation settlement (1)

                  2,588          2,500        240     

Restructuring (2)

                  806          551            

Depreciation and amortization

    195        1,288        3,003          1,399        2,228     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total operating expenses

    26,415        62,796        112,208          54,848        56,556     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income from operations

    1,860        3,239        3,533          4,483        2,647     

Interest expense

    337        980        1,390          784        705     

Other (income) expense, net

           12        36          (27     15     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income before income tax expense

    1,523        2,247        2,107          3,726        1,927     

Income tax expense

    652        1,148        615          1,745        859     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income

    871        1,099        1,492          1,981        1,068     

Less: net loss (income) attributable to noncontrolling interest (3)

           405        (706       (343     668     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to AAC Holdings, Inc. stockholders

    871        1,504        786          1,638        1,736     

Deemed contribution—redemption of Series B Preferred Stock

                  1,000          1,000            

BHR Series A Preferred Unit dividend

                                  (203  
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income available to AAC Holdings, Inc. common stockholders

  $ 871      $ 1,504      $ 1,786      $        $ 2,638      $ 1,533      $     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Earnings per share attributable to common stockholders (4):

             

Basic

  $ 0.20      $ 0.19      $ 0.20      $        $ 0.30      $ 0.16      $     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Diluted

  $ 0.20      $ 0.19      $ 0.20      $        $ 0.30      $ 0.16      $     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Weighted-average shares outstanding:

             

Basic

    4,287,131        7,770,359        8,819,062          8,671,942        9,510,427     

Diluted

    4,314,051        7,869,017        9,096,660          8,734,934        9,544,420     

Other Financial Information:

             

Adjusted EBITDA (5)

  $ 2,055      $ 7,168      $ 11,558      $        $ 9,580      $ 7,832      $     

 

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                As of June 30, 2014  
    As of December 31,     Actual
(unaudited)
    Pro Forma
as Adjusted (6)
 
       2012           2013         
    (in thousands)  

Balance Sheet Data:

       

Cash and cash equivalents

  $ 740      $ 2,012      $ 2,382      $                

Working capital

    3,190        1,220        3,729     

Total assets

    53,598        81,638        93,752     

Total debt, including current portion

    25,222        43,075        46,794     

Total mezzanine equity (including noncontrolling
interest) (7)

    11,613        11,842        7,835     

Total stockholders’ equity (including noncontrolling
interest) (8)

    4,678        11,883        26,497     

 

     Year Ended
December 31,
     Six Months Ended
June 30
 
     2012      2013          2013              2014      

Operating Metrics (unaudited):

           

Average daily census (9)

     238         339         365         376   

Average daily revenue (10)

   $ 759       $ 935       $ 906       $ 872   

Average net daily revenue (11)

   $ 722       $ 847       $ 827       $ 779   

New admissions (12)

     2,934         4,053         2,174         2,177   

Bed count at end of period (13)

     338         431         420         427   

 

(1) We recorded a $2.5 million reserve in the second quarter of 2013 in connection with a consolidated wage and hour class action claim. We made a payment of $2.6 million in the second quarter of 2014 to settle the matter. For additional discussion of this litigation settlement, see Note 16 to our audited financial statements included elsewhere in this prospectus.

 

(2) During the first half of 2013, management adopted restructuring plans to centralize our call centers and to close the Leading Edge facility. As a result, aggregate restructuring and exit charges of $0.8 million were recognized in 2013, of which $0.6 million was recognized in the six months ended June 30, 2013. We did not recognize any restructuring expenses during 2012 as expenses related to the corporate relocation were not significant.

 

(3) Represents the net income attributable to the stockholders of AAC that did not exchange their shares for Holdings common stock for the period from April 15, 2014 to June 30, 2014, the net income (loss) attributable to the noncontrolling interest in BHR (for 2012, 2013 and through the acquisition date of April 15, 2014) and the Professional Groups (as defined in “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Consolidation of VIEs” ) (for 2013 and the six month period ended June 30, 2014) and the net income (loss) in the Pro Forma as Adjusted columns of the Professional Groups.

 

(4) After giving effect to the subsidiary short-form merger with AAC that we expect to complete subsequent to this offering, pro forma basic and diluted earnings per share attributable to common stockholders would be              and             , respectively, based on pro forma basic and diluted weighted-average shares outstanding of                      and                     , respectively.

 

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(5) Adjusted EBITDA is a “non-GAAP financial measure” as defined under the rules and regulations promulgated by the SEC. We define Adjusted EBITDA as net income adjusted for interest expense, depreciation and amortization expense, income tax expense, stock-based compensation and related tax reimbursements, litigation settlement and restructuring charges and acquisition related de novo startup expenses, which includes professional services for accounting, legal and valuation services related to the acquisitions and legal and licensing expenses related to de novo projects. Adjusted EBITDA, as presented in this prospectus, is considered a supplemental measure of our performance and is not required by, or presented in accordance with, GAAP. Adjusted EBITDA is not a measure of our financial performance under GAAP and should not be considered as an alternative to net income or any other performance measures derived in accordance with GAAP. We have included information concerning Adjusted EBITDA in this prospectus because we believe that such information is used by certain investors as a measure of a company’s historical performance. We believe this measure is frequently used by securities analysts, investors and other interested parties in the evaluation of issuers of equity securities, many of which present EBITDA and Adjusted EBITDA when reporting their results. Because Adjusted EBITDA is not determined in accordance with GAAP, it is subject to varying calculations and may not be comparable to the Adjusted EBITDA (or similarly titled measures) of other companies. Our presentation of Adjusted EBITDA should not be construed as an inference that our future results will be unaffected by unusual or nonrecurring items. The following table presents a reconciliation of Adjusted EBITDA to net income, the most comparable GAAP measure, for each of the periods indicated:

 

                Year Ended
December 31, 2013
    Six Months
Ended

June 30,
        2013         
Actual
(unaudited)
    Six Months Ended
June 30, 2014
 
    Year Ended December 31,           Pro Forma
as Adjusted
      Actual
(unaudited)
    Pro Forma
as Adjusted
 
        2011             2012         Actual          
    (in thousands)  

Net Income

  $ 871      $ 1,099      $ 1,492      $                   $ 1,981      $ 1,068      $                

Non-GAAP Adjustments:

             

Interest expense

    337        980        1,390          784        705     

Depreciation and amortization

    195        1,288        3,003          1,399        2,228     

Income tax expense

    652        1,148        615          1,745        859     

Stock-based compensation and related tax reimbursements

           2,408        1,649          605        1,776     

Litigation settlement

                  2,588          2,500        240     

Restructuring

                  806          551            

Acquisition related and
de novo start-up expenses

           245        15          15        956     
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA

  $ 2,055      $ 7,168      $ 11,558      $                   $ 9,580      $ 7,832      $                
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

(6) Reflects the issuance of              shares of Holdings common stock at the initial public offering price of $         per share (the midpoint of the price range set forth on the cover page of this prospectus) and the estimated net proceeds of $         and a use of a portion of the proceeds to repay approximately $         million of outstanding indebtedness. Each $1.00 increase or decrease in the assumed initial public offering price of $         per share, the midpoint of the price range set forth on the cover page of this prospectus, would increase or decrease, as applicable, our cash and cash equivalents, working capital, total assets and total stockholders’ equity by approximately $         million, assuming the number of shares offered by us, as set forth on the cover page of this prospectus, remains the same and after deducting estimated underwriting discounts and commissions and estimated offering expenses payable by us.

 

(7) For additional discussion of mezzanine equity and noncontrolling interest, see Note 11 to our audited financial statements included elsewhere in this prospectus.

 

(8) Noncontrolling interest represents the equity of BHR (through April 15, 2014) and the Professional Groups (as defined in “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Consolidation of VIEs”) that we do not own as well as the outstanding shares of AAC common stock that were not exchanged for shares of Holdings common stock.

 

(9) Includes client census at all of our owned or leased inpatient facilities, including FitRx, as well as beds obtained through contractual arrangements to meet demand exceeding capacity. For additional information about contracted beds, see “Revenues” under Note 3 to our audited financial statements included elsewhere in this prospectus.

 

(10) Average daily revenue is calculated as total revenues during the period divided by the product of the number of days in the period multiplied by average daily census.

 

(11) Average net daily revenue is calculated as total revenues less provision for doubtful accounts during the period divided by the product of the number of days in the period multiplied by average daily census.

 

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(12) Includes total client admissions for the period presented.

 

(13) Bed count at end of period includes all beds at owned and leased inpatient facilities, including FitRx, but excludes contracted beds as of December 31, 2012. We did not have any contracted beds as of any other period presented. Bed count at the end of the 2012 period includes 70 beds at our former Leading Edge facility, which was closed in the second quarter of 2013. For additional information regarding the closure of the Leading Edge facility, see Note 13 to our audited financial statements included elsewhere in this prospectus. In the first quarter of 2014, we added two beds at the FitRx facility to accommodate increased client census and eliminated six beds at The Academy facility as a result of an expired housing lease. In addition, the Greenhouse expansion, completed in July 2014, added 60 beds, all of which are licensed for detoxification.

 

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MANAGEMENT’S DISCUSSION AND ANALYSIS OF

FINANCIAL CONDITION AND RESULTS OF OPERATIONS

The following discussion and analysis of our financial condition and results of operations should be read together with our financial statements and related notes included elsewhere in this prospectus. This discussion and analysis contains forward-looking statements that are based upon current expectations and involve risks, assumptions and uncertainties. You should review the “Risk Factors” section of this prospectus for a discussion of important factors that could cause actual results to differ materially from the results described in or implied by the forward-looking statements described in the following discussion and analysis.

Overview

General . We believe we are a leading provider of inpatient substance abuse treatment services for individuals with drug and alcohol addiction. As of July 31, 2014, we operated six substance abuse treatment facilities located throughout the United States, focused on delivering effective clinical care and treatment solutions across our 467 beds, which included 338 licensed detoxification beds. We are currently developing three facilities and have an additional property under contract that we plan to develop into a new facility. The majority of our 715 employees are highly trained clinical staff who deploy research-based treatment programs with structured curricula for detoxification, residential treatment, partial hospitalization and intensive outpatient care. By applying a tailored treatment program based on the individual needs of each client, many of whom require treatment for a co-occurring mental health disorder, such as depression, bipolar disorder and schizophrenia, we believe we offer the level of quality care and service necessary for our clients to achieve and maintain sobriety.

De Novo Facilities . We have completed two successful de novo development projects. In March 2012, we opened Greenhouse in a suburb of Dallas, Texas, which initially provided us with 70 licensed residential and detoxification beds. In January 2013, we opened Desert Hope in Las Vegas, Nevada, which provided us with 148 licensed residential and detoxification beds. We refer to these two development projects as the “De Novo Facilities.” Both facilities were extensively renovated and remodeled to convert them into high quality inpatient treatment centers, and each achieved profitability in its first year of operation. We believe we were able to quickly increase census at our De Novo Facilities through increased sales and marketing efforts prior to each facility opening. As a result of the BHR Acquisition in April 2014, we acquired ownership of the real estate properties on which the De Novo Facilities operate. The effect of the BHR Acquisition is reflected under “Unaudited Pro Forma Consolidated Financial Statements.”

TSN Facilities . On August 31, 2012, we acquired the outpatient treatment operations of Singer Island (65 beds in West Palm Beach, Florida), The Academy (12 beds in West Palm Beach, Florida) and Leading Edge (70 beds in Trenton, New Jersey) (collectively, the “TSN Facilities”), for an aggregate purchase price of $14.6 million (collectively, the “TSN Acquisition”). In connection with the TSN Acquisition, we issued 888,868 shares of AAC common stock (662,452 unrestricted shares and 226,416 restricted shares at a fair value of $6.27 per share), valued collectively at $5.6 million; paid cash of $2.5 million from proceeds received from bank financing; and issued $6.5 million of subordinated notes to the sellers to fund the acquisition. The purchase agreement includes provisions that contemplate a potential purchase price adjustment at the August 2015 maturity of the subordinated notes issued to the sellers. If certain operational performance metrics are not achieved during the three-year term of the subordinated notes, we may withhold up to $1.5 million of the $4.0 million balloon payment at maturity with respect to the subordinated notes and cause the forfeiture of up to 226,416 restricted shares of AAC common stock. The TSN Acquisition provided us with a professional sales force and a referral network of hospitals, other treatment facilities, employers, alumni, and employee assistance programs, along with established internet sites and toll free numbers. Collectively, these sales channels have contributed to an increase in our average monthly admissions of 96 clients from September 2012 through June 2014. The Leading Edge facility was later closed by management in the second quarter of 2013 because management determined the amenities and service offerings at the facility were inconsistent with our long-term strategy and brand.

 

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Corporate Relocation . In 2012, we moved our corporate offices to Brentwood, Tennessee from Temecula, California. In 2012, we also opened a centralized call center; staffed our marketing department to transition outsourced marketing activities in-house; expanded our accounting and finance department to accommodate the financial reporting needs of a more mature, seasoned company; and added human resource, IT and operations personnel to meet the demands of our rapid growth.

Recent Developments. In April 2014, we completed the Reorganization Transactions in preparation for this offering. These included the Private Share Exchange, BHR Acquisition and CRMS Acquisition. BHR owns all the outstanding equity interests of Concorde Real Estate, LLC, Greenhouse Real Estate, LLC and The Academy Real Estate, LLC, which entities own the Desert Hope, Greenhouse and Riverview, Florida properties, respectively, and CRMS provides our client billing and collection services. For additional information related to the Reorganization Transactions, see Note 3 to our unaudited condensed consolidated financial statements included elsewhere in this prospectus. In May 2014, we completed the purchase of an approximately 20,000 square foot property in Las Vegas, Nevada for $2.0 million. We paid $1.9 million at closing and a $0.1 million deposit was applied to the purchase price. In July 2014, we began construction of an outpatient treatment facility at this location.

Subsequent to this offering, we expect to conduct a subsidiary short-form merger with AAC whereby the legacy holders of AAC common stock who did not participate in the Private Share Exchange would be entitled to receive Holdings shares on a one-for-one basis. Upon completion of the short-form merger, Holdings would own 100% of AAC. No assurance can be given that the short-form merger will occur in a timely manner or at all.

Anticipated Obligations and Requirements with Becoming a Public Company . As a public company, we expect that we will incur significant additional costs and expenses such as increased legal and audit fees, professional fees, directors’ and officers’ insurance costs, expenses related to compliance with Sarbanes-Oxley regulations and other annual costs of doing business as a public company, including hiring additional personnel and expanding our administrative functions.

Revenues . Our revenues primarily consist of service charges related to providing addiction treatment and other ancillary services associated with serving our clients, such as the collection and laboratory testing of urine for controlled substances. We recognize revenues at the estimated net realizable value in the period in which services are provided. For the year ended December 31, 2013 and the six months ended June 30, 2014, approximately 90% of our revenues were reimbursable by commercial payors, including amounts paid by such payors to clients, with the remaining revenues payable directly by our clients. Given the scale and nationwide reach of our network of substance abuse treatment facilities, we generally have the ability to serve clients located across the country from any of our facilities, which allows us to operate our business and analyze revenue on a system-wide basis rather than focusing on any individual facility. For the year ended December 31, 2013 and the six months ended June 30, 2014, no single payor accounted for more than 12.3% and 14.5% of our revenue reimbursements, respectively. We estimate that revenues derived from point-of-care drug testing, quantitative laboratory services, professional groups and other ancillary services accounted for approximately 23% of our revenues for the six months ended June 30, 2014.

We recognize revenues from commercial payors at the time services are provided based on our estimate of the amount that payors will pay us for the services performed. We estimate the net realizable value of revenues by adjusting gross client charges using our expected realization and applying this discount to gross client charges. Through December 31, 2013, our expected realization was determined by management after taking into account historical collections received from the commercial payors since our inception compared to the gross client charges billed. Beginning in January 2014, we enhanced our methodology related to our net realizable value to more quickly react to potential changes in reimbursements by facility, by type of service and by payor. As a result, management adjusted the expected realization discount, on a per facility basis, to reflect a twelve-month historical analysis of reimbursement data by facility in addition to considering the type of services provided, the payors and the gross client charge rates by facility.

 

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Our accounts receivable primarily consists of amounts due from commercial payors. The client self-pay portion is usually collected upon admission and in limited circumstances the client will make a deposit and negotiate the remaining payments as part of the services. We do not recognize revenue for any amounts not collected from the client in either of these situations. From time to time we may provide free care to a limited number of clients, which we refer to as scholarships. We do not recognize revenues for scholarships provided. Included in the aging of accounts receivable are amounts for which the commercial insurance company paid out-of-network claims directly to the client and for which the client has yet to remit the insurance payment to us (which we refer to as “paid to client”). Such amounts paid to clients continue to be reflected in our accounts receivable aging as amounts due from commercial payors. Accordingly, our accounts receivable aging does not provide for the distinct identification of paid to client receivables.

Operating Expenses. Our operating expenses are primarily impacted by eight categories of expenses: salaries, wages and benefits; advertising and marketing; professional fees; client related services; other operating expenses; rentals and leases; provision for doubtful accounts; and depreciation and amortization.

 

    Salaries, wages and benefits. We employ a variety of staff related to providing client care including case managers, therapists, medical technicians, housekeepers, cooks and drivers, among others. Our clinical salaries, wages and benefits expense is largely driven by the total number of beds in our facilities and our average daily census. We also employ a professional sales force and staff a centralized call center. Our corporate staff includes accounting, billing and finance professionals, marketing and human resource personnel, IT staff and senior management.

 

    Advertising and marketing. We promote our treatment facilities through a variety of channels including television advertising, internet search engines and Yellow Page advertising, among others. While we do not compensate our referral sources for client referrals, we do have arrangements with multiple marketing channels that we pay on a performance basis (i.e., pay per click or pay per inbound call). We also host and attend industry conferences. Our advertising and marketing efforts and expense is largely driven by the total number of available beds in our facilities.

 

    Professional fees . Professional fees consist of various professional services used to support primarily corporate related functions. These services include client billings and collections, accounting related fees for financial statement audits and tax preparation and legal fees for, among other matters, employment, compliance and general corporate matters. These fees also consist of information technology, consulting, payroll fees and national medical director fees.

 

    Client related services . Client related services consist of physician and medical services as well as client meals, pharmacy, travel, and various other expenses associated with client treatment, including the cost of contractual arrangements for the treatment of clients where the demand for services exceed our capacity. Client related services are significantly influenced by our average daily census.

 

    Other operating expenses. Other operating expenses consists primarily of utilities, insurance, telecom, travel and repairs and maintenance expenses, and is significantly influenced by the total number of beds in our facilities and our average daily census.

 

    Rentals and leases. Rentals and leases mainly consist of properties under various equipment and operating leases, which includes space required to perform client services and space for administrative facilities.

 

   

Provision for doubtful accounts . The provision for doubtful accounts represents the expense associated with management’s best estimate of accounts receivable that could become uncollectible in the future. We establish our provision for doubtful accounts based on the aging of the receivables, historical collection experience by facility, services provided, payor source and historical reimbursement rate, current economic trends and percentages applied to the accounts receivable aging categories. As of June 30, 2014, all accounts receivable aged greater than 360 days were fully reserved in our consolidated financial statements. In assessing the adequacy of the allowance for doubtful accounts, we

 

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rely on the results of detailed reviews of historical write-offs and recoveries (the hindsight analysis) as a primary source of information to utilize in estimating the collectability of our accounts receivable. We perform the hindsight analysis on a quarterly basis, utilizing rolling twelve-month accounts receivable collection, write-off and recovery data. We supplement this hindsight analysis with other analytical tools, including, but not limited to, historical trends in cash collections compared to net revenues less bad debt and days sales outstanding. During the second quarter of 2014, management analyzed the past two years of accounts receivable collection and write-off history and the current projected bad debt write-offs for all client accounts covered by insurance. Based on the results of this analysis, including improvements noted in the credit quality of receivables aged 120-180 days, management concluded that the current methodology for establishing the allowance for doubtful accounts resulted in, and would continue to result in, an overstatement of the reserve requirement. As a result, management revised the estimates used to establish the provision for doubtful accounts, effective as of the second quarter of 2014. This change in estimate reduced the reserve percentages applied to various aging classes of accounts receivable aged less than 360 days to more closely reflect actual collection and write-off history that we have experienced and expect to experience in the future.

 

    Depreciation and amortization. Depreciation and amortization represents the ratable use of our capitalized property and equipment, including assets under capital leases, over the estimated useful lives of the assets, and amortizable intangible assets, which mainly consist of trademark-related intangibles and non-compete agreements.

Key Drivers of Our Results of Operations . Our results of operations and financial condition are affected by numerous factors, including those described above under “Risk Factors” and elsewhere in this prospectus and those described below:

 

    Average Daily Census . We refer to the average number of clients to whom we are providing services on a daily basis over a specific period as our “average daily census.” Our revenues are directly impacted by our average daily census, which fluctuates based on the effectiveness of our sales and marketing efforts, total number of beds, the number of client admissions and discharges in a period, average length of stay, and the ratio of clinical staff to clients.

 

    Average Daily Revenue and Average Net Daily Revenue . Our average daily revenue is a per census metric equal to our total revenues for a period divided by our average daily census for the same period divided by the number of days in the period. Our average net daily revenue is a per census metric equal to our total revenues less provision for doubtful accounts for a period divided by our average daily census for the same period divided by the number of days in the period. The key drivers of average daily revenue and average net daily revenue include the mix of services and level of care that we provide to our clients during the period and payor mix. We provide a broad continuum of services including detoxification, residential treatment, partial hospitalization and intensive outpatient care, with detoxification resulting in the highest daily charges and intensive outpatient care resulting in the lowest daily charges. We also generate revenues from laboratory and other ancillary services associated with serving our clients. We tend to experience higher margins from our urinalysis testing services, which are conducted both on-site at all of our treatment facilities and at our centralized laboratory facility in Brentwood, Tennessee, than we do from other ancillary services.

 

    Expense Management. Our profitability is directly impacted by our ability to manage our expenses, most notably salaries, wages and benefits and advertising and marketing costs, and to adjust accordingly based upon our capacity.

 

    Billing and Collections. Our revenues and cash flow are directly impacted by our ability to properly verify our clients’ insurance benefits, obtain authorization for levels of care, properly submit insurance claims and manage collections.

 

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Results of Operations

Comparison of Six Months ended June 30, 2014 to Six Months ended June 30, 2013

The following table presents our consolidated statements of income from continuing operations for the periods indicated (dollars in thousands):

 

    Six Months Ended June 30,     Six Month over Six Month
Increase (Decrease)
 
    2013 (unaudited)     2014 (unaudited)    
        Amount             %             Amount             %             Amount             %      

Revenues

  $ 59,331        100.0      $ 59,203        100.0      $ (128     (0.2
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating expenses

           

Salaries, wages and benefits

    21,732        36.6        24,124        40.7        2,392        11.0   

Advertising and marketing

    6,588        11.1        7,079        12.0        491        7.5   

Professional fees

    4,706        7.9        4,895        8.3        189        4.0   

Client related services

    3,567        6.0        5,211        8.8        1,644        46.1   

Other operating expenses

    6,213        10.5        5,551        9.4        (662     (10.7

Rentals and leases

    2,772        4.7        940        1.6        (1,832     (66.1

Provision for doubtful accounts

    4,820        8.1        6,288        10.6        1,468        30.5   

Litigation settlement

    2,500        4.2        240        0.4        (2,260     (90.4

Restructuring

    551        0.9                      (551     (100.0

Depreciation and amortization

    1,399        2.4        2,228        3.8        829        59.3   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total operating expenses

    54,848        92.4        56,556        95.5        1,708        3.1   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income from operations

    4,483        7.6        2,647        4.5        (1,836     (41.0

Interest expense

    784        1.3        705        1.2        (79     (10.1

Other (income) expense, net

    (27     0.0        15        0.0        42        n/m   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income before income tax expense

    3,726        6.3        1,927        3.3        (1,799     (48.3

Income tax expense

    1,745        2.9        859        1.5        (886     (50.8
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income

  $ 1,981        3.3      $ 1,068        1.8      $ (913     (46.1

Less: net loss (income) attributable to noncontrolling interest

    (343     (0.6     668        1.1        1,011        n/m   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to AAC Holdings, Inc. stockholders

  $ 1,638        2.8      $ 1,736        2.9      $ 98        6.0   

Deemed contribution — redemption of Series B Preferred Stock

    1,000        1.7               0.0        (1,000       

BHR Series A Preferred Units dividend

                  (203     (0.0     (203     n/m   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income available to AAC Holdings, Inc. common stockholders

  $ 2,638        4.4      $ 1,533        2.6      $ (1,105     (41.9
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

n/m — not meaningful

Revenues

Revenues decreased $0.1 million, or 0.2%, to $59.2 million for the six months ended June 30, 2014 from $59.3 million for the six months ended June 30, 2013. Revenues were positively impacted by an increase in average daily census to 376 for the six months ended June 30, 2014 from 365 for the six months ended June 30, 2013, or 3.0%, and an increase in revenues derived from point-of-care drug testing, quantitative laboratory services, professional groups and other ancillary services. These increases were offset by a decrease in average daily revenue to $872 for the six months ended June 30, 2014 from $906 for the six months ended June 30, 2013, or 3.8%. The increase in average daily census was driven by the expansion of both our outside sales force and our national advertising program. The increase in point-of-care drug testing, quantitative laboratory services, professional groups and other ancillary services was primarily driven by the opening of our

 

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laboratory in Brentwood, Tennessee in September 2013 and the consolidation of the Professional Groups in October 2013. The decrease in average daily revenue was primarily the result of a decline in our collection percentage as expressed as a percentage of gross client charges. This decline was principally driven by lower than estimated collections for Desert Hope for which we had limited operating history and a new commercial network agreement and, to a lesser extent, laboratory revenues for which we had limited operating history. We have since instituted further clinical placement review procedures with respect to Desert Hope to ensure maximum program benefits through the participating commercial network programs, and we have improved our laboratory billing practices by adding primary diagnosis codes and enhancing patient claim information. While we believe these actions should improve collection percentages, there can be no assurances that we will be able to maintain or improve historical collection rates in future reporting periods.

In addition, as previously disclosed, through December 31, 2013, our expected realization was determined by management after taking into account historical collections received from the commercial payors since our inception compared to the gross client charges billed. Beginning in January 2014, we enhanced our methodology related to our net realizable value to more quickly react to potential changes in reimbursements by facility, by type of service and by payor. As a result, management adjusted the expected realization discount, on a per facility basis, to reflect a twelve-month historical analysis of reimbursement data by facility in addition to considering the type of services provided, the payors and the gross client charge rates by facility. This adjustment resulted in a decrease in our expected realization for the first six months of 2014. Although we are unable to quantify the future effects of this change in methodology, we currently anticipate this adjustment will decrease our expected realization and net realizable value of revenues over the remainder of 2014.

Salaries, Wages and Benefits

Salaries, wages and benefits increased $2.4 million, or 11.0%, to $24.1 million for the six months ended June 30, 2014 from $21.7 million for the six months ended June 30, 2013. As a percentage of revenues, salaries, wages and benefits were 40.7% of revenues for the six months ended June 30, 2014 compared to 36.6% of revenues for the six months ended June 30, 2013. The increase was primarily related to the impact of stock compensation expense for the six months ended June 30, 2014 compared to the six months ended June 30, 2013 relating to the vesting of equity award grants under our 2007 Stock Incentive Plan. Our Chief Operating Officer commenced employment in February 2013 and our General Counsel and Secretary commenced employment in December 2013. Accordingly, our salaries, wages and benefits for the six months ended June 30, 2014 included their salaries for the entire period of 2014. In addition, salaries, wages and benefits for the six months ended June 30, 2014 increased $0.6 million for discretionary bonuses.

The increase was also impacted by the addition of staff in connection with the CRMS Acquisition in April 2014. As a result of the CRMS Acquisition, we expect the increase in headcount with the addition of CRMS personnel will contribute approximately $1.1 million in additional salaries, wages and benefits expense for the second half of 2014. In addition, we expect the opening of the Greenhouse expansion in July 2014 will contribute $0.2 million in additional salaries, wages and benefits expense for the period in 2014 subsequent to the completion of the expansion.

 

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Advertising and Marketing

Advertising and marketing expenses increased $0.5 million, or 7.5%, to $7.1 million for the six months ended June 30, 2014 from $6.6 million for the six months ended June 30, 2013. As a percentage of revenues, advertising and marketing expenses were 12.0% of revenues for the six months ended June 30, 2014 compared to 11.1% of revenues for the six months ended June 30, 2013. The increase was primarily driven by the expansion of our national advertising program, an increased emphasis on internet advertising campaigns and marketing efforts targeted at increasing census in anticipation of our Greenhouse facility expansion, which was completed in July 2014.

Professional Fees

Professional fees increased $0.2 million, or 4.0%, to $4.9 million for the six months ended June 30, 2014 from $4.7 million for the six months ended June 30, 2013. As a percentage of revenues, professional fees were 8.3% of revenues for the six months ended June 30, 2014 compared to 7.9% of revenues for the six months ended June 30, 2013. The increase was primarily due to the engagement of temporary accounting professionals in connection with the preparation for this offering and related non-capitalized costs.

Client Related Services

Client related services expenses increased $1.6 million, or 46.1%, to $5.2 million for the six months ended June 30, 2014 from $3.6 million for the six months ended June 30, 2013. As a percentage of revenues, client related services expenses were 8.8% of revenues for the six months ended June 30, 2014 compared to 6.0% of revenues for the six months ended June 30, 2013. The increase was primarily related to increases in clinician fees paid to the Professional Groups due to greater census in detoxification and residential beds which require greater numbers of more highly qualified medical staff. Detoxification and residential treatment services accounted for 27% of total billed days for the six months ended June 30, 2014 compared to 18% of total billed days for the six months ended June 30, 2013.

Other Operating Expenses

Other operating expenses decreased $0.7 million, or 10.7%, to $5.6 million for the six months ended June 30, 2014 from $6.2 million for the six months ended June 30, 2013. As a percentage of revenues, other operating expenses were 9.4% of revenues for the six months ended June 30, 2014 compared to 10.5% of revenues for the six months ended June 30, 2013. The decrease was primarily attributable to the closure of the Leading Edge facility in June 2013.

Rentals and Leases

Rentals and leases decreased $1.8 million, or 66.1%, to $0.9 million for the six months ended June 30, 2014 from $2.8 million for the six months ended June 30, 2013. As a percentage of revenues, rentals and leases were 1.6% of revenues for the six months ended June 30, 2014 compared to 4.7% of revenues for the six months ended June 30, 2013. The decrease was primarily related to a $0.7 million reduction in rent expense resulting from the consolidation of Greenhouse Real Estate, LLC effective October 8, 2013, a $0.5 million reduction related to the closure of the Leading Edge facility in June 2013, a $0.5 million reduction related to a change in lease arrangements at the Singer Island facility and a $0.1 million reduction related to the closure of the California and Florida call centers.

We expect to continue to experience a reduction in rent expense for the remainder of 2014 of $1.2 million related to the acquisition of Greenhouse Real Estate, LLC, partially offset by a $0.1 million increase in rent expense for the remainder of 2014 as a result of the CRMS Acquisition.

 

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Provision for Doubtful Accounts

The provision for doubtful accounts increased $1.5 million, or 30.5%, to $6.3 million for the six months ended June 30, 2014 from $4.8 million for the six months ended June 30, 2013. As a percentage of revenues, the provision for doubtful accounts was 10.6% of revenues for the six months ended June 30, 2014 compared to 8.1% of revenues for the six months ended June 30, 2013. Our provision for doubtful accounts is directly impacted by the aging of our receivables, and accounts receivable aged over 180 days increased by $7.4 million to $18.3 million as of June 30, 2014 from $11.0 million as of June 30, 2013. The increase of accounts receivable aged over 180 days was driven by the increase in total revenues from California and Nevada. In these states, two large commercial payors directly reimburse clients instead of remitting payments to us, which requires greater collections efforts, extends payment times and reduces recovery amounts.

As previously described, we establish our provision for doubtful accounts based on the aging of receivables, historical collection experience by facility, services provided, payor source and historical reimbursement rate, current economic trends and percentages applied to the accounts receivable aging categories. During the second quarter of 2014, management analyzed the past two years of accounts receivable collection and write-off history and the current projected bad debt write-offs for all client accounts covered by insurance. Based on the results of this analysis, including improvements noted in the credit quality of receivables aged 120-180 days, management concluded that the current methodology for establishing the allowance for doubtful accounts resulted in, and would continue to result in, an overstatement of the reserve requirement. As a result, management revised the estimates used to establish the provision for doubtful accounts, effective as of the second quarter of 2014. This change in estimate reduced the reserve percentages applied to various aging classes of accounts receivable aged less than 360 days to more closely reflect actual collection and write-off history that we have experienced and expect to experience in the future. The impact of reducing the reserve percentages was approximately $1.5 million in the second quarter of 2014.

The following table presents a summary of our aging of accounts receivable as of June 30, 2013 and 2014:

 

     Current     30-180
Days
    Over 180
Days
    Total  

June 30, 2013

     19.8     47.5     32.7     100.0

June 30, 2014

     23.4     35.4     41.2     100.0

Our days sales outstanding as of June 30, 2013 and 2014 were 72 and 81, respectively.

Litigation Settlement

Litigation settlement expense decreased $2.3 million, or 90.4%, to $0.2 million for the six months ended June 30, 2014 from $2.5 million for the six months ended June 30, 2013. As a percentage of revenues, litigation settlement expense was 0.4% of revenues for the six months ended June 30, 2014 compared to 4.2% of revenues for the six months ended June 30, 2013. The decrease was primarily the result of lower settlements in the six months ended June 30, 2014 as compared to the $2.5 million settlement of the wage and hour class action claim during the six months ended June 30, 2013.

Restructuring

Restructuring expenses for the six months ended June 30, 2013 were $0.6 million. During the first half of 2013, management adopted restructuring plans to centralize our call centers and to close the Leading Edge facility acquired in the TSN Acquisition. As a result, aggregate restructuring and exit charges of $0.6 million were recognized in the first half of 2013. No restructuring expenses were recognized for the six months ended June 30, 2014.

The Leading Edge facility was closed in June 2013. Management elected to close the facility because the amenities and the service offerings at the facility were inconsistent with our long-term strategy. During the

 

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transition period leading up to closing, clients that would have been candidates for the Leading Edge facility were referred to other treatment facilities, primarily Desert Hope. As a result of the facility closure, we recorded restructuring and exit charges of $0.5 million in the six months ended June 30, 2013. These charges consisted of $0.2 million of payroll, severance and employee related costs and facility exit costs related to ongoing lease obligations of approximately $0.3 million.

Two call centers were closed in the third quarter of 2013 and were consolidated with the existing call center at our headquarters in Brentwood, Tennessee to create a centralized call center. The call center operations were centralized in order to manage costs more effectively and optimize the call center’s view of client services, thus streamlining the placement of clients to treatment facilities. Restructuring expenses related to centralizing the call centers totaled $0.1 million in the six months ended June 30, 2013 related to severance and relocation costs.

Depreciation and Amortization

Depreciation and amortization expense increased $0.8 million, or 59.3%, to $2.2 million for the six months ended June 30, 2014 from $1.4 million for the six months ended June 30, 2013. As a percentage of revenues, depreciation and amortization expense was 3.8% of revenues for the six months ended June 30, 2014 compared to 2.4% of revenues for the six months ended June 30, 2013. The increase was primarily the result of the consolidation of Greenhouse Real Estate, LLC in October 2013. The increase in depreciation and amortization expense was also attributable to additions of property and equipment in the last nine months of 2013 and the six months ended June 30, 2014.

We expect to record an additional $0.2 million in depreciation expense during the remainder of 2014 related to a full year consolidation of Greenhouse Real Estate, LLC plus an additional $0.1 million in depreciation expense associated with the opening of the Greenhouse expansion in July 2014.

Interest Expense

Interest expense decreased slightly to $0.7 million for the six months ended June 30, 2014 compared to $0.8 million for the six months ended June 30, 2013. As a percentage of revenues, interest expense was 1.2% of revenues for the six months ended June 30, 2014 compared to 1.3% of revenues for the six months ended June 30, 2013. We expect to incur an additional $0.2 million in interest expense for the remainder of 2014 related to the consolidation of Greenhouse Real Estate, LLC, and we expect to incur approximately $0.2 million of additional interest expense on construction financing related to the Greenhouse expansion, which was completed in July 2014.

Other (Income) Expense

Other expense was $15,000 for the six months ended June 30, 2014 compared to other income of $27,000 for the six months ended June 30, 2013.

Income Tax Expense

For the six months ended June 30, 2014, income tax expense was $0.9 million, reflecting an effective tax rate of 44.6%, compared to $1.7 million, reflecting an effective tax rate of 46.8%, for the six months ended June 30, 2013. As a percentage of revenue, income tax expense was 1.5% of revenues for the six months ended June 30, 2014 compared to 2.9% of revenues for the six months ended June 30, 2013. The decreases in income tax expense and the effective tax rate for the six months ended June 30, 2014 were primarily attributable to a decrease in the valuation allowances related to net losses of the Professional Groups and to our forecasted net taxable income.

Net Loss (Income) Attributable to Noncontrolling Interest

For the six months ended June 30, 2014, net loss attributable to noncontrolling interest was $0.7 million compared to net income attributable to noncontrolling interest of $0.3 million for the six months ended June 30, 2013, representing a $1.0 million decrease. This decrease was primarily the result of the consolidation of Greenhouse Real Estate, LLC effective October 8, 2013 and the consolidation of the Professional Groups effective October 1, 2013.

 

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Comparison of Year ended December 31, 2013 to Year ended December 31, 2012

The following table presents our consolidated statements of income from continuing operations for the periods indicated (dollars in thousands):

 

     Year Ended December 31,              
     2012      2013     Year over Year
  Increase (Decrease)  
 
     Amount      %      Amount     %     Amount     %  

Revenues

   $ 66,035         100.0       $ 115,741        100.0      $ 49,706        75.3   
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Operating expenses

              

Salaries, wages and benefits

     25,680         38.9         46,856        40.5        21,176        82.5   

Advertising and marketing

     8,667         13.1         13,493        11.7        4,826        55.7   

Professional fees

     5,430         8.2         10,277        8.9        4,847        89.3   

Client related services

     8,389         12.7         7,986        6.9        (403     (4.8

Other operating expenses

     6,384         9.7         11,615        10.0        5,231        81.9   

Rentals and leases

     3,614         5.5         4,634        4.0        1,020        28.2   

Provision for doubtful accounts

     3,344         5.1         10,950        9.5        7,606        227.5   

Litigation settlement

                     2,588        2.2        2,588          

Restructuring

                     806        0.7        806          

Depreciation and amortization

     1,288         1.9         3,003        2.6        1,715        133.2   
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Total operating expenses

     62,796         95.1         112,208        97.0        49,412        78.7   
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Income from operations

     3,239         4.9         3,533        3.0        294        9.1   

Interest expense

     980         1.5         1,390        1.2        410        41.8   

Other expense, net

     12         0.0         36        0.0        24        200.0   
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Income before income tax expense

     2,247         3.4         2,107        1.8        (140     (6.2

Income tax expense

     1,148         1.7         615        0.5        (533     (46.4
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Net income

   $ 1,099         1.7       $ 1,492        1.3      $ 393        35.8   

Less: net loss (income) attributable to noncontrolling interest

     405         0.6         (706     (0.6     1,111        n/m   
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to AAC Holdings, Inc.

   $ 1,504         2.3       $ 786        0.7      $ (718     (47.7
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Deemed contribution — redemption of Series B Preferred Stock

                     1,000        0.8        1,000          
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Net income available to AAC Holdings, Inc. common stockholders

   $ 1,504         2.3       $ 1,786        1.5      $ 282        18.8   
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

n/m = not meaningful

Revenues

Revenues increased $49.7 million, or 75.3%, to $115.7 million for the year ended December 31, 2013 from $66.0 million for the year ended December 31, 2012. The increase resulted primarily from our average daily census increasing to 339 in 2013 from 238 in 2012, or 42.4%, and average daily revenue increasing to $935 in 2013 from $759 in 2012, or 23.2%. This growth was attributable to opening the De Novo Facilities as well as added capacity from the TSN Facilities.

Revenues generated from our De Novo Facilities were $52.9 million in 2013 compared to $13.8 million in 2012. The substantial increase was the result of the opening dates of the new facilities. The 70-bed Greenhouse facility started accepting clients in March 2012, and the 148-bed Desert Hope facility opened in January 2013. In addition, the TSN Facilities generated revenues of $24.1 million in 2013 compared to $11.0 million in 2012. The year-over-year increase with respect to the TSN Facilities was the result of a full year of revenues recorded during 2013, while 2012 only included a relatively short partial year with respect to these facilities. The additional

 

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sales channels provided by the TSN Acquisition also contributed to the revenue increase by improving our average daily census. The increases in revenues were offset by a $3.5 million decrease at other existing facilities.

As previously noted, we closed one of the TSN Facilities (Leading Edge) in the second quarter of 2013; however, our other facilities were able to absorb the majority of the closed facility’s clients, resulting in an insignificant loss of consolidated revenues.

Salaries, Wages and Benefits

Salaries, wages and benefits increased $21.2 million, or 82.5%, to $46.9 million for the year ended December 31, 2013 from $25.7 million for the year ended December 31, 2012. As a percentage of revenues, salaries, wages and benefits were 40.5% of revenues for the year ended December 31, 2013 compared to 38.9% of revenues for the year ended December 31, 2012. The increase was primarily related to (i) the addition of 208 employees in connection with the TSN Acquisition and 97 employees in conjunction with the opening of Desert Hope in January 2013 and (ii) an increase in our corporate staff, including the expansion of our sales force and call center. In addition, our total number of employees has grown to 629 at December 31, 2013 from 231 at the beginning of 2012. In addition, salaries, wages and benefits expense for the year ended December 31, 2013 included $3.5 million of discretionary bonuses of cash and stock in December 2013 to our executive officers, of which $2.5 million was paid or granted as of December 31, 2013 and $1.0 million is included in accrued liabilities on the consolidated balance sheet at December 31, 2013.

As a result of the CRMS Acquisition in April 2014, we expect that salaries, wages and benefits will increase by approximately $1.5 million in 2014 with the addition of 31 personnel. In addition, we expect salaries, wages and benefits will increase approximately $0.2 million in 2014 related to the opening of the Greenhouse expansion in July 2014.

Advertising and Marketing

Advertising and marketing expenses increased $4.8 million, or 55.7%, to $13.5 million for the year ended December 31, 2013 from $8.7 million for the year ended December 31, 2012. As a percentage of revenues, advertising and marketing expenses were 11.7% of revenues for the year ended December 31, 2013 compared to 13.1% of revenues for the year ended December 31, 2012. The year-over-year increase was primarily driven by the expansion of our national advertising program, particularly targeted television advertising, in connection with the opening of the De Novo Facilities and the TSN Acquisition. A heightened emphasis on internet advertising campaigns also contributed to the increase in advertising expense.

Professional Fees

Professional fees increased $4.8 million, or 89.3%, to $10.3 million for the year ended December 31, 2013 from $5.4 million for the year ended December 31, 2012. As a percentage of revenues, professional fees were 8.9% of revenues for the year ended December 31, 2013 compared to 8.2% of revenues for the year ended December 31, 2012. The increase was primarily due to an increase in service fees for outsourced medical billing and collections. Our demand for these services significantly increased in mid-2012 and again in early 2013 pro-

 

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portional with revenues generated from the opening and ramp-up of the De Novo Facilities and the addition of the TSN Facilities. The increase was also attributable to an increase in legal fees incurred in connection with the wage and hour class action lawsuit and settlement discussed below.

During 2013, all of our medical billing and collections were transitioned to a single billing service, CRMS. The transition from other third party billers in 2013 combined with the CRMS Acquisition is expected to result in a reduction in customer billing and collection fees of approximately $2.9 million in 2014.

Client Related Services

Client related services expenses decreased $0.4 million, or 4.8%, to $8.0 million for the year ended December 31, 2013 from $8.4 million for the year ended December 31, 2012. As a percentage of revenues, client related services expenses were 6.9% of revenues for the year ended December 31, 2013 compared to 12.7% of revenues for the year ended December 31, 2012. The decrease was primarily related to greater reliance in 2012 on subcontracted services to accommodate clients exceeding the Company’s capacity. The opening of the De Novo Facilities and the addition of the TSN Facilities substantially decreased the need for these subcontracted services, resulting in a decrease of subcontracted services expenses to $0.8 million in 2013 from $5.4 million in 2012. However, the decrease in subcontracted services expenses was partially offset by additional client related expenses attributable to the 70-bed Greenhouse facility that started accepting clients in March 2012, the 148-bed Desert Hope facility that opened in January 2013, a full year of expenses for the TSN Facilities and additional expenses at existing facilities.

Other Operating Expenses

Other operating expenses increased $5.2 million, or 81.9%, to $11.6 million for the year ended December 31, 2013 from $6.4 million for the year ended December 31, 2012. As a percentage of revenues, other operating expenses were 10.0% of revenues for the year ended December 31, 2013 compared to 9.7% of revenues for the year ended December 31, 2012. The increase was the result of additional operating expenses associated with the opening of Greenhouse in March 2012 and Desert Hope in January 2013 and the addition of the TSN Facilities in August 2012. Other operating expenses as a percentage of revenues was relatively unchanged, as these expenses typically correlate with the number of beds in our facilities. We expect other operating expenses will increase approximately $0.4 million in 2014 as a result of the CRMS Acquisition.

Rentals and Leases

Rentals and leases increased $1.0 million, or 28.2%, to $4.6 million for the year ended December 31, 2013 from $3.6 million for the year ended December 31, 2012. As a percentage of revenues, rentals and leases declined to 4.0% of revenues for the year ended December 31, 2013 compared to 5.5% of revenues for the year ended December 31, 2012. The year-over-year dollar increase was primarily related to the TSN Acquisition, as we did not begin paying rent on the TSN Facilities until September 2012. A full year of rent for the TSN Facilities (excluding rent for the Leading Edge facility after its closure in June 2013) is included in rentals and leases for 2013. All rent transactions with the real estate entities consolidated as variable interest entities are eliminated effective from June 27, 2012 for Concorde Real Estate, LLC and October 8, 2013 for Greenhouse Real Estate, LLC, with minimal year-over-year impact to expense. We expect to experience a reduction in rent expense in 2014 of approximately $2.1 million related to consolidating Greenhouse Real Estate, LLC for an entire year and expect rent expense will increase by $0.1 million with the acquisition of CRMS.

Provision for Doubtful Accounts

The provision for doubtful accounts increased $7.6 million, or 227.5%, to $11.0 million for the year ended December 31, 2013 from $3.3 million for the year ended December 31, 2012. As a percentage of revenues, the provision for doubtful accounts was 9.5% of revenues for the year ended December 31, 2013 compared to 5.1% of revenues for the year ended December 31, 2012. Our provision for doubtful accounts is directly impacted by the aging of our receivables, and accounts receivable aged over 120 days increased by $10.7 million to $18.2 million as of December 31, 2013 from $7.5 million as of December 31, 2012. The increase of accounts receivable aged at over

 

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120 days was driven by the significant growth in revenues in 2013, which increased receivables as a whole across all aging periods; transition issues encountered when our billing and collection functions were combined from multiple providers to CRMS during 2013; payment delays normally associated with the opening of new facilities, such as Desert Hope in January 2013, due to being an out-of-network provider with a limited operating history; and the increase of total revenues from California and Nevada where two large commercial payors in these markets pay their portion directly to the client instead of us, which requires greater collections efforts, extends payment times and reduces recovery amounts. As a result of the foregoing factors, our provision for doubtful accounts reflects a higher reserve percentage due to uncertainty of collecting these accounts.

The following table presents a summary of our aging of accounts receivable as of December 31, 2012 and 2013:

 

     Current     30-120
Days
    Over 120
Days
    Total  

December 31, 2012

     23.5     39.4     37.1     100.0

December 31, 2013

     22.8     28.8     48.4     100.0

Our days sales outstanding as of December 31, 2012 and 2013 were 115 and 77, respectively. The improvement in days sales outstanding from 2012 to 2013 was primarily the result of consolidation of our billing and collections processing from three companies to one.

Litigation Settlement

Litigation settlement expenses for the year ended December 31, 2013 were $2.6 million. In September 2012, a wage and hour class-action claim was filed against us in the State of California. In March 2013, an amended complaint alleging additional wage and hour violations was filed against us in the same court, and the two claims were subsequently consolidated into a class action. In June 2013, the parties agreed to settle the substantive claims for $2.6 million during mediation. Once the settlement amount became probable, we recorded a $2.5 million reserve in the second quarter of 2013 for this matter. The reserve is reflected in accrued liabilities as of December 31, 2013. On April 9, 2014 and following court approval, we settled this matter with a payment of $2.6 million. We did not record any litigation settlement expenses for the year ended December 31, 2012.

Restructuring

Restructuring expenses for the year ended December 31, 2013 were $0.8 million. During the first half of 2013, management adopted restructuring plans to centralize our call centers and to close the Leading Edge facility acquired in the TSN Acquisition. As a result, aggregate restructuring and exit charges of $0.8 million were recognized in 2013. We did not recognize any restructuring expenses during 2012 as expenses related to the corporate headquarters relocation were not significant.

The Leading Edge facility was closed in June 2013. Management elected to close the facility because the amenities and the service offerings at the facility were inconsistent with our long-term strategy. During the transition period leading up to closing, clients that would have been candidates for the Leading Edge facility were referred to other treatment facilities, primarily Desert Hope. As a result of the facility closure, we recorded restructuring and exit charges of $0.5 million. These charges consisted of $0.2 million of payroll, severance and employee related costs and facility exit costs related to ongoing lease obligations of $0.3 million. We estimate that approximately $0.3 million of aggregate cash payments related to lease obligations will be made from 2014 through January 2017 as the related leases expire.

Two call centers were closed in the third quarter of 2013 and were consolidated with the existing call center at our headquarters in Brentwood, Tennessee to create a centralized call center. The call center operations were centralized in order to manage costs more effectively and optimize the call center’s view of client services, thus streamlining the placement of clients to treatment facilities. Restructuring expenses related to centralizing the call centers totaled $0.3 million in 2013, which included $0.1 million related to payroll, severance and other

 

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employee related costs, $0.1 million related to relocation costs and $0.1 million of facility exit costs related to ongoing lease obligations (net of approximately $0.1 million in sublease income). We estimate that approximately $0.2 million of aggregate cash payments related to these lease obligations will be made from 2014 through October 2015 as the related leases expire.

Depreciation and Amortization

Depreciation and amortization expense increased $1.7 million, or 133.2%, to $3.0 million for the year ended December 31, 2013 from $1.3 million for the year ended December 31, 2012. As a percentage of revenues, depreciation and amortization expense was 2.6% of revenues for the year ended December 31, 2013 compared to 1.9% of revenues for the year ended December 31, 2012. The increase was primarily the result of a full year of expense in 2013 related to the TSN Facilities, combined with depreciation expense associated with Desert Hope, which we began recording in January 2013 when that facility was opened, and to a lesser extent, depreciation related to the consolidation of Greenhouse in October 2013. The increase in depreciation and amortization expense was also attributable to additions of property and equipment during 2013 of $14.1 million, including capital lease obligations of $1.2 million. Also contributing to the increase was the addition of depreciable assets associated with the expansion of our call center.

We expect to record an additional $0.2 million in depreciation expense during 2014 related to a full year consolidation of the existing Greenhouse facility plus an additional $0.1 million in depreciation expense associated with the opening of the Greenhouse expansion in July 2014.

Interest Expense

Interest expense increased $0.4 million, or 41.8%, to $1.4 million for the year ended December 31, 2013 from $1.0 million for the year ended December 31, 2012. As a percentage of revenues, interest expense was 1.2% of revenues for the year ended December 31, 2013 compared to 1.5% of revenues for the year ended December 31, 2012. The year-over-year dollar increase was associated with $17.9 million in net additional borrowings in 2013 to fund growth and acquisitions, including $14.2 million in additional VIE debt and $1.0 million in new capital leases. We expect interest expense to increase $0.3 million in 2014 related to the consolidation of Greenhouse, and we expect to incur approximately $0.1 million of additional interest on construction financing for the Greenhouse expansion, which was completed in July 2014.

Income Tax Expense

For the year ended December 31, 2013, income tax expense was $0.6 million, reflecting an effective tax rate of 29.2%, compared to $1.1 million, reflecting an effective tax rate of 51.1%, for the year ended December 31, 2012. As a percentage of revenue, income tax expense was 0.5% of revenues for the year ended December 31, 2013 compared to 1.7% of revenues for the year ended December 31, 2012. Our effective tax rate on income applicable to AAC was 54.8% in 2013 compared to 44.3% in 2012. The increase in the effective tax rate on income applicable to AAC was primarily due to an increase in non-deductible expenses, an increase in the valuation allowance and the recognition of uncertain tax positions. The reduction in our overall effective tax rate was primarily attributable to additional income that is not taxable to us from various VIEs that we are consolidating in our results of operations, partially offset by increases in non-deductible expenses and an increase in the valuation allowance. Other items affecting our overall tax rate include the release of previously established valuation allowances, a reduction to our apportioned state income tax rate and various adjustments arising from amended tax returns filed during 2013.

Net Loss (Income) Attributable to Noncontrolling Interest

For the year ended December 31, 2013, net income attributable to noncontrolling interest was $0.7 million compared to a net loss attributable to noncontrolling interest of $0.4 million for the year ended December 31, 2012, representing a $1.1 million, or 274.3%, increase. This increase is principally a result of the consolidation of Concorde Real Estate for all twelve months in 2013, compared to the period from June 27, 2012 through December 31, 2012, and the consolidation of Greenhouse Real Estate from October 8, 2013 through December 31, 2013.

 

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Quarterly Results of Operations

The following tables set forth unaudited quarterly condensed consolidated statements of operations data for the last two fiscal years and the six months ended June 30, 2014. We have prepared the statement of operations for each of these quarters on the same basis as the audited consolidated financial statements included elsewhere in this prospectus. In the opinion of management, the quarterly financial information reflects all necessary adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of this data. This information should be read in conjunction with the audited consolidated financial statements and related notes and the unaudited condensed consolidated financial statements and related notes included elsewhere in this prospectus. These quarterly operating results are not necessarily indicative of our operating results for any future quarters or for a full year.

 

    Three Months Ended  
    Mar. 31,
2012
    June 30,
2012
    Sept. 30,
2012
    Dec. 31,
2012
    Mar. 31,
2013
    June 30,
2013
    Sept. 30,
2013
    Dec. 31,
2013
    Mar. 31,
2014
    June 30,
2014
 
    (dollars in thousands, except average daily revenue and average net daily revenue)  

Revenues

  $ 10,173      $ 12,220      $ 16,616      $ 27,026      $ 29,004      $ 30,327      $ 28,350      $ 28,060      $ 30,083      $ 29,120   

Operating expenses

    10,064        11,490        13,698        27,544        25,092        29,756 (7)       26,471        30,889 (8)       28,231        28,325   

Income (loss) before income tax expense

    (1     553        2,716        (1,021     3,504        222        1,382        (3,001     1,456        471   

Net income (loss)

    (3     311        1,494        (703     2,126        (145     1,479        (1,968     841        227   

Adjusted EBITDA (1)

    259        1,053        3,286        2,570        4,933        4,647        3,059        (1,081     3,592        4,240   

Operating Metrics:

                   

Average daily census (2)

    206        176        232        337        368        361        318        309        371        379   

Average daily revenue (3)

  $ 559      $ 745      $ 778      $ 871      $ 889      $ 923      $ 968      $ 972      $ 901      $ 843   

Average net daily revenue (4)

  $ 516      $ 725      $ 765      $ 813      $ 809      $ 844      $ 866      $ 877      $ 776      $ 782   

New admissions (5)

    695        604        674        961        1,097        1,077        935        944        1,065        1,112   

Bed count at end of period (6)

    194        194        338        338        486        420        431        431        427        427   

 

(1) Adjusted EBITDA is a “non-GAAP financial measure” as defined under the rules and regulations promulgated by the SEC. We define Adjusted EBITDA as net income adjusted for interest expense, depreciation and amortization expense, income tax expense, stock-based compensation and related tax reimbursements, litigation settlement and restructuring charges and acquisition related de novo startup expenses, which includes professional services for accounting, legal and valuation services related to the acquisitions and legal and licensing expenses related to de novo projects. Adjusted EBITDA, as presented in this prospectus, is considered a supplemental measure of our performance and is not required by, or presented in accordance with, GAAP. Adjusted EBITDA is not a measure of our financial performance under GAAP and should not be considered as an alternative to net income or any other performance measures derived in accordance with GAAP. We have included information concerning Adjusted EBITDA in this prospectus because we believe that such information is used by certain investors as a measure of a company’s historical performance. We believe this measure is frequently used by securities analysts, investors and other interested parties in the evaluation of issuers of equity securities, many of which present EBITDA and Adjusted EBITDA when reporting their results. Because Adjusted EBITDA is not determined in accordance with GAAP, it is subject to varying calculations and may not be comparable to the Adjusted EBITDA (or similarly titled measures) of other companies. Our presentation of Adjusted EBITDA should not be construed as an inference that our future results will be unaffected by unusual or nonrecurring items. The following table presents a reconciliation of Adjusted EBITDA to net income, the most comparable GAAP measure, for each of the periods indicated:

 

    Three Months Ended  
    Mar. 31,
2012
    June 30,
2012
    Sept. 30,
2012
    Dec. 31,
2012
    Mar. 31,
2013
    June 30,
2013
    Sept. 30,
2013
    Dec. 31,
2013
    Mar. 31,
2014
    June 30,
2014
 
    (dollars in thousands)  

Net income (loss)

  $ (3   $ 311      $ 1,494      $ (703   $ 2,126      $ (145   $ 1,479      $ (1,968   $ 841      $ 227   

Non-GAAP Adjustments:

                   

Interest expense

    110        172        211        487        446        338        375        231        354        351   

Depreciation and amortization

    132        243        266        647        665        734        729        875        1,077        1,151   

Income tax expense (benefit)

    2        242        1,222        (318     1,378        367        (97     (1,033     615        244   

Stock-based compensation and related tax reimbursements

                         2,408        303        302        318        726        705        1,071   

Litigation settlement

                                       2,500               88               240   

Restructuring

                                       551        255                        

Acquisition related and de novo start-up expenses

    18        85        93        49        15                                    956   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted EBITDA

  $ 259      $ 1,053      $ 3,286      $ 2,570      $ 4,933      $ 4,647      $ 3,059      $ (1,081   $ 3,592      $ 4,240   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

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(2) Includes client census at all of our owned or leased inpatient facilities, including FitRx, as well as beds obtained through contractual arrangements to meet demand exceeding capacity. For additional information about contracted beds, see “Revenues” under Note 3 to our audited financial statements included elsewhere in this prospectus.

(3) Average daily revenue is calculated as total revenues during the period divided by the product of the number of days in the period multiplied by average daily census.

(4) Average net daily revenue is calculated as total revenues less provision for doubtful accounts during the period divided by the product of the number of days in the period multiplied by average daily census.

(5) Includes total client admissions for the period presented.

(6) Bed count at end of period includes all beds at owned and leased inpatient facilities, including FitRx, but excludes contracted beds as of December 31, 2012. We did not have any contracted beds as of any other period presented. Bed count at the end of the 2012 period includes 70 beds at our former Leading Edge facility, which was closed in the second quarter of 2013. For additional information regarding the closure of the Leading Edge facility, see Note 13 to our audited financial statements included elsewhere in this prospectus. In the first quarter of 2014, we added two beds at the FitRx facility to accommodate increased client census and eliminated six beds at The Academy facility as a result of an expired housing lease. In addition, the Greenhouse expansion, completed in July 2014, added 60 beds, all of which are licensed for detoxification.

(7) Includes $2.6 million for litigation settlement expenses in connection with a consolidated wage and hour class action claim. In the quarter ended June 30, 2013, we determined that the likelihood of an unfavorable outcome was probable and, accordingly, we accrued a litigation settlement liability of $2.5 million. The parties agreed to settle the substantive claims during mediation for $2.6 million, and we made a payment of $2.6 million in the second quarter of 2014 to settle the matter. For additional discussion of this litigation settlement, see Note 16 to our audited financial statements included elsewhere in this prospectus.

(8) Includes $3.5 million for discretionary bonuses to our executive officers in December 2013.

Liquidity and Capital Resources

General

Our primary sources of liquidity are net cash generated from operations, borrowing availability under our revolving line of credit, other bank financings, proceeds from issuances of our common stock, seller financing and the issuance of subordinated debt. We have also utilized operating lease transactions with respect to commercial properties primarily to perform client services and provide space for administrative facilities. For additional information regarding operating leases, see Note 16 to our audited financial statements included elsewhere in this prospectus. We expect that our future funding for working capital needs, capital expenditures, long-term debt repayments and other financing activities will continue to be provided from some or all of these sources and with the proceeds from this offering. Our future liquidity will be impacted by our ability to access capital markets, which may be restricted due to our credit ratings, general market conditions, leverage capacity and by existing or future debt agreements.

We anticipate that our current level of cash on hand, internally generated cash flows and borrowings available under our revolving line of credit, without taking into account the net proceeds from this offering, will be sufficient to fund our anticipated working capital needs, debt service and repayment obligations, dividend payments to noncontrolling interests and maintenance capital expenditures for at least the next twelve months.

One element of our business strategy is to selectively pursue facility acquisitions, consisting of both existing operating facilities and properties purchased for remodeling which may be closed for operations at the time of acquisition. We are currently evaluating potential facility acquisitions consistent with the normal course of our business and have one property under contract. These and other potential acquisitions are in various stages of evaluation and there can be no assurance as to whether or when any of these acquisitions will be completed. Our ability to complete acquisitions is subject to a number of risks and variables, including our ability to negotiate mutually agreeable terms with the counterparties and our ability to finance the purchase price. Any acquisitions may result in the incurrence of, or assumption by us, of additional indebtedness. We continually assess our capital needs and may seek additional financing, including debt or equity as considered necessary to fund capital expenditures (inclusive of facility expansions), de novo facilities, potential acquisitions and for other corporate purposes. We intend to fund the development of our recently acquired properties in Riverview, Florida, Arlington, Texas and Las Vegas, Nevada through, and subject to the availability of, future bank financings secured by the properties, utilizing our revolving line of credit and/or cash on hand.

 

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We cannot provide assurance that our operating performance will continue to generate sufficient cash flows from operations or that future borrowings will be available under existing or future financing arrangements or otherwise to enable us to grow our business, service or repay our debt or make anticipated capital expenditures. Our future capital requirements and the adequacy of available funds will depend on many factors, including those set forth under “Risk Factors” in this prospectus. We may not be able to secure additional financing to finance anticipated acquisition or development costs or to meet our debt service or repayment requirements on acceptable terms, or at all. If we raise additional funds by issuing additional shares of common stock, the ownership of our existing stockholders will be diluted. If we raise additional financing by incurring new indebtedness, we will be subject to increased fixed payment obligations and could also be subject to restrictive covenants, such as limitations on our ability to incur additional debt and other operating restrictions that could adversely impact our ability to conduct our business. If we are unable to obtain necessary additional funds, we will have to reduce our operating costs, which could impair our growth prospects and could otherwise negatively impact our business.

Cash Flow Analysis

Our cash flows are summarized as follows (in thousands):

 

     Year Ended
December 31,
    Year over
Year
Increase
(Decrease)
    Six Months Ended
June 30,
(unaudited)
    Six Month
over
Six Month
Increase
(Decrease)
 
     2012     2013       2013     2014    

Provided by (used in) operating activities

   $ 69      $ 3,443      $ 3,374      $ (77   $ (30   $ 47   

Used in investing activities

     (7,896     (13,144     (5,248     (8,895     (12,615     (3,720

Provided by financing activities

     8,434        10,973        2,539        8,303        13,015        4,712   

Net increase in cash and cash equivalents

     607        1,272        665        (669     370        1,039   

Cash and cash equivalents at end of period

     740        2,012        1,272        71        2,382        2,311   

Net Cash Provided by (Used in) Operating Activities

Cash used in operating activities was $30,000 for the six months ended June 30, 2014, a decrease of $47,000 compared to cash used in operating activities of $77,000 for the six months ended June 30, 2013. The decrease was primarily attributable to an increase in non-cash charges of $3.5 million, principally resulting from an increase in our provision for doubtful accounts, an increase in depreciation and amortization expense related to the TSN Facilities, the consolidation of certain variable interest entities and our investment in corporate infrastructure and a decreased investment in working capital of $2.6 million, primarily related to our accounts receivable, accounts payable and accrued liabilities. These increases were offset by a decrease in net income of $0.9 million.

Cash provided by operating activities was $3.4 million for the year ended December 31, 2013, an increase of $3.4 million compared to cash provided by operating activities of $69,000 for the year ended December 31, 2012. The increase was primarily attributable to an increase in net income of $0.4 million and an increase in non-cash charges of $7.7 million, principally from an increase in our provision for doubtful accounts and depreciation and amortization related to the TSN Facilities and equity compensation, the consolidation of certain variable interest entities and our investment in corporate infrastructure. These increases were offset by our increase in working capital of $4.7 million resulting from the increase in our accounts receivable and a decrease in accrued liabilities.

Net Cash Used in Investing Activities

Cash used in investing activities was $12.6 million for the six months ended June 30, 2014, an increase of $3.7 million compared to cash used in investing activities of $8.9 million for the six months ended June 30, 2013. The increase was primarily related to $3.4 million paid in connection with the BHR Acquisition and CRMS Acquisition and $0.2 million for the purchase of other assets. In addition, cash used in investing activities includes $0.5 million in advances to our CEO and President.

 

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Cash used in investing activities was $13.1 million for the year ended December 31, 2013, an increase of $5.2 million, or 66.5%, compared to cash used in investing activities of $7.9 million for the year ended December 31, 2012. The increase was primarily related to $5.8 million paid in connection with our purchase of land and a building in Riverview, Florida that we are converting to a treatment facility and an additional $0.6 million in related renovations. We also invested $1.0 million related to construction projects at Greenhouse and $4.7 million for other purchases, mainly furniture, equipment and leasehold improvements.

Net Cash Provided by Financing Activities

Cash provided by financing activities was $13.0 million for the six months ended June 30, 2014, an increase of $4.7 million compared to cash provided by financing activities of $8.3 million for the six months ended June 30, 2013. The increase was primarily related to proceeds of $8.2 million from the sale of BHR Series A Preferred Units.

Cash provided by financing activities was $11.0 million for the year ended December 31, 2013, an increase of $2.5 million compared to cash provided by financing activities of $8.4 million for the year ended December 31, 2012. Financing activities in fiscal 2013 included $5.9 million in borrowing under our then existing revolving line of credit, the issuance of notes payable totaling $9.2 million, $7.4 million in proceeds from the sale of AAC common stock and $2.0 million in contributions by certain variable interest entities, which were offset in part by our debt principal payments of $4.0 million and distributions to and redemptions of BHR interests totaling $4.4 million.

Financing Relationships

Credit Facility

On April 15, 2014, we entered into the Second Amended and Restated Credit Agreement (the “Credit Facility”) with Wells Fargo Bank, National Association. The Credit Facility makes available to us a $15.0 million revolving line of credit, subject to borrowing base limitations, and amended and restated two existing term loans in the outstanding principal amounts of $0.6 million (“Term Loan A”) and $1.5 million (“Term Loan B”). The Credit Facility, as amended in June 2014, also provides for standby letters of credit in an aggregate undrawn amount not to exceed $3.0 million, and in July 2014 Wells Fargo issued on our behalf an irrevocable standby letter of credit in the amount of $700,000. We intend to use the proceeds of the revolving line of credit for general corporate purposes. The proceeds of Term Loan B were used to fund a portion of the consideration paid in connection with the TSN Acquisition. The revolving line of credit matures on April 1, 2015 and the outstanding principal balance of Term Loan A is due and payable in full on May 15, 2017. The revolving line of credit bears interest at the one-month London Interbank Offered Rate (“LIBOR”), plus an applicable margin that is determined by our leverage ratio, as defined by the agreement, at the end of each quarter. A quarter-end leverage ratio of 4.75 to 1.00 or above results in an applicable margin of 3.0%, a ratio below 4.75 to 1.00 and equal to or above 4.00 to 1.00 results in an applicable margin of 2.75%, and a ratio below 4.00 to 1.00 results in an applicable margin of 2.5%. Term Loan A bears interest at LIBOR plus 3.15%. The borrowing base for the revolving line of credit is 70% of our eligible accounts receivable and was established with the understanding that, among other things, the aggregate of all returns, rebates, discounts, credits and allowances, exclusive of the initial adjustment to record net revenues at the time of billing, for the immediately preceding three months will be less than 20% of gross revenues for such period. If the aggregate of all returns, rebates, discounts, credits and allowances, exclusive of the initial adjustment to record net revenues at the time of billing, for the immediately preceding three months is greater than 20% of gross revenues for such period, or if there exists any other matters, events, conditions or contingencies that Wells Fargo Bank reasonably believes may affect payment of any portion of our accounts, the borrowing base may be reduced to a lower percentage of our eligible accounts receivable.

 

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The Credit Facility requires us to achieve minimum net revenues and adjusted EBITDA for each quarter, determined on a rolling four quarters basis, of no less than 85% of net revenues and adjusted EBITDA for the immediately preceding four quarters. The Credit Facility generally defines adjusted EBITDA as consolidated net income plus (i) interest expense, (ii) depreciation and amortization expense, (iii) tax expense, (iv) non-cash stock compensation, (v) one-time legal and restructuring costs incurred in 2014 in connection with the AAC private placement, the Reorganization Transactions, the BHR preferred equity transactions, and this offering in an amount not to exceed $2.5 million, (vi) one-time legal, accounting and other transaction costs incurred in connection with a permitted acquisition in 2014 or in any subsequent fiscal year in an aggregate amount not to exceed $0.2 million in any fiscal year, (vii) one-time settlement costs paid on or about April 9, 2014, in connection with certain wage and settlement charges in California in an amount not to exceed $2.5 million, (viii) one-time restructuring costs incurred in 2013 in connection with the closing of the Leading Edge operations and the consolidation of call centers in an amount not to exceed $0.8 million and (ix) to the extent approved by Wells Fargo Bank in writing, other one-time and non-recurring charges.

The Credit Facility also requires us to achieve a fixed charge coverage ratio of not less than 1.25 to 1.00 for each quarter, determined on a rolling four quarter basis, and achieve a liquidity covenant (as described in the Credit Agreement) of no less than $9.0 million on and as of July 14, 2014. In June 2014, we entered into a letter amendment with Wells Fargo pursuant to which we agreed to prepay in full the outstanding balance of $1.5 million plus accrued and unpaid interest under Term Loan B. In connection with the June 2014 prepayment of Term Loan B, the parties agreed to remove from the Credit Agreement the covenant of achieving liquidity of no less than $9.0 million as of July 14, 2014. Finally, the Credit Facility includes a maximum leverage ratio covenant, whereby the ratio of funded debt to EBITDA must not be greater than the ratios set forth below on a rolling four quarter basis:

 

Fiscal Quarter End

   Maximum Leverage Ratio  

June 30, 2014

     5.00:1.00   

September 30, 2014

     4.75:1.00   

December 31, 2014 and thereafter

     3.75:1.00   

The Credit Facility limits aggregate capital expenditures (as defined in the Credit Agreement and which exclude, among other items, capital expenditures made by BHR and its subsidiaries that are funded with debt permitted under the Credit Agreement or proceeds from this offering and permitted acquisitions under the Credit Agreement) to $3.0 million in each fiscal year and limits capital lease debt and other purchase money debt to $2.3 million.

The Credit Facility also contains customary events of default including, but not limited to, failure to make payments under the Credit Facility, breaches of covenants (subject to a 20-day cure period in the case of certain covenants), cross-default to any other material indebtedness, bankruptcy and insolvency events and change of control.

We were not in compliance with certain financial covenants contained in our then existing line of credit at the end of each quarter in 2012 and 2013, including as of December 31, 2012 and 2013. Additionally, our capital expenditures, total operating leases and incurrence of additional indebtedness exceeded the limits specified in our then existing line of credit for the year ended December 31, 2013. For the quarter ended March 31, 2014, we were not in compliance with the covenants regarding capital expenditures and the incurrence of additional indebtedness. We obtained a waiver for the covenant defaults for 2012, and the amendment and restatement of our prior credit facility in April 2014 included a waiver for the noncompliance of the financial covenants and negative covenants that occurred in 2013 and the quarter ended March 31, 2014. In addition, the noncompliance under our then existing line of credit created a cross-default with respect to the note under Term Loan B, and we obtained a waiver for the cross-default under Term Loan B. As previously stated, the Credit Facility contains new covenants that were negotiated in consideration of our operating budget over the term of the Credit Facility and we were in compliance with all such covenants as of June 30, 2014.

 

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As of June 30, 2014, the revolving line of credit had an outstanding balance of $13.0 million, the interest rate was 3.15%, and the maximum unused available credit was $1.3 million based upon the borrowing base restrictions.

We intend to use a portion of the net proceeds from this offering to repay all amounts outstanding under the revolving line of credit but may re-borrow such amounts in the future.

BHR Debt

In conjunction with the consolidation of our variable interest entities, our June 30, 2014 balance sheet included debt of $26.8 million related to BHR, which owns all of the outstanding equity interests of Concorde Real Estate, LLC, Greenhouse Real Estate, LLC and The Academy Real Estate, LLC, which entities own the Desert Hope, Greenhouse and Riverview, Florida properties, respectively. As a result of the Reorganization Transactions completed in April 2014, we now own 100% of the outstanding common membership interests in BHR. The BHR debt is guaranteed on a joint and several basis by AAC, Mr. Cartwright and Mr. Menz. The floating interest rates on the BHR debt are based upon the one-month LIBOR, as defined by each agreement, plus various percentage points. The terms of each BHR debt agreement are summarized below:

 

    Concorde Real Estate, LLC: The debt with respect to Concorde Real Estate, LLC (the “Concorde Loan”) is represented by a $9.6 million promissory note used to refinance the indebtedness related to our Desert Hope facility and to redeem the preferred membership interests in Concorde Real Estate, LLC. The note requires monthly principal payments of $53,228 plus monthly interest and a balloon payment of $6.6 million due at maturity. The note is secured by a deed of trust and an assignment of leases and rents. The note contains financial covenants that require us to maintain a fixed charge coverage ratio of not less than 1.25 to 1.00. The note also contains a cross-default provision linking the performance of Concorde Real Estate to the occurrence of a default by its guarantors or affiliates of its guarantors with respect to any other indebtedness. The interest rate at June 30, 2014 was 2.65% and the balance was $8.9 million. The maturity date of the note is May 15, 2018. In July 2014, we executed a new interest rate swap agreement with respect to the Concorde Loan to effectively fix the interest rate at 4.16%. The interest rate swap has an effective date of July 15, 2014, has a notional amount of $8.9 million and is scheduled to mature on May 15, 2018.

 

    Greenhouse Real Estate, LLC: The debt with respect to Greenhouse Real Estate, LLC (the “Greenhouse Loan”) was previously represented by a $13.2 million promissory note used to refinance the indebtedness related to our Greenhouse facility in Grand Prairie, Texas and to fund a 60-bed expansion of the Greenhouse facility. Monthly draws were made against the note based on actual construction costs incurred. The interest rate at June 30, 2014 was 3.15% and the balance was $12.5 million. In July 2014, we executed a new interest rate swap agreement with respect to the Greenhouse Loan to effectively fix the interest rate at 4.62%. The interest rate swap has an effective date of September 1, 2014, has a notional amount of $13.2 million and is scheduled to mature on October 31, 2019. Pursuant to the terms of the previous loan agreement, in August 2014 we converted the note into a permanent loan that extended the maturity date to August 2019 and adjusted the interest rate to a rate of one month LIBOR plus 2.5%. The amended and restated permanent loan is represented by a new $12.7 million promissory note. The new note requires monthly principal payments of $70,778 plus monthly interest and a balloon payment of $8.5 million due at maturity. We intend to amend the interest rate swap agreement as a result of the terms of the new note to reflect a lower notional amount. The new note is secured by a deed of trust and an assignment of leases and rents. We are required to maintain a debt service coverage ratio of not less than 1.25 to 1.00. The new note also contains a cross-default provision.

 

   

The Academy Real Estate, LLC: At June 30, 2014, the debt with respect to The Academy Real Estate, LLC (the “Academy Loan”) was represented by a $3.6 million promissory note used to purchase the property in Riverview, Florida. The note is secured by a deed of trust and an assignment of leases and rents. The note contains financial covenants that require us to maintain a fixed charge coverage ratio of not less than 1.25 to 1.00, as well as other restrictive financial covenants. The note also contains a cross-default provision linking the performance of The Academy Real Estate, LLC to the occurrence of a default by its guarantors or affiliates of its guarantors with respect to any other indebtedness. The

 

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interest rate at June 30, 2014 was 3.15% and the balance was $3.6 million. In April 2014, we effected an amendment to the Academy Loan to extend the maturity date to July 14, 2019. Under the amended Academy Loan, we will make monthly principal payments of $30,000 commencing in October 2014 and a balloon payment of remaining unpaid principal of $1.9 million at the maturity date.

 

    Behavioral Healthcare Realty, LLC: In October 2013, our CEO, President and CFO, who then owned membership interests in BHR, personally borrowed $1.9 million from a financial institution, and used the proceeds to make a $1.9 million equity contribution to BHR. In connection with the BHR Acquisition, we assumed this term loan. Subsequent to our assumption of this term loan, we refinanced the term loan with Holdings as the borrower, and it is now guaranteed by our CEO, President, CFO and AAC. The balance of this term loan at June 30, 2014 was $1.7 million. The Credit Facility requires that this term loan be repaid with proceeds from this offering.

At June 30, 2014, we were in compliance with the financial covenants of the BHR debt. We were not on compliance with certain financial covenants contained in the Credit Facility in 2012, 2013 and as of March 31, 2014. The instances of noncompliance under the Credit Facility created a cross-default with the Greenhouse Loan, the Concorde Loan and the Academy Loan. We obtained a waiver for the covenant defaults under the Credit Facility for 2012, and the amendment and restatement of our prior credit facility in April 2014 included a waiver for the noncompliance of the financial covenants and negative covenants that occurred under the Credit Facility in 2013 and the quarter ended March 31, 2014. We also obtained waivers for the cross-defaults under the Greenhouse Loan, the Concorde Loan and the Academy Loan.

BHR Preferred Equity

In October 2013, BHR amended its limited liability company agreement to permit the issuance of Series A Preferred Units. In the fourth quarter of 2013, BHR received proceeds of $1.4 million from the sale of 28 Series A Preferred Units valued at $50,000 per unit. In January and February 2014, BHR sold 8.5 Series A Preferred Units, valued at $50,000 per unit, with proceeds to BHR of $0.4 million, net of issuance costs of $11,300. As part of this redemption, one of our directors received $250,000 and an entity controlled by the spouse of one of our directors received $200,000. After these transactions, 36.5 Series A Preferred Units were outstanding. The unit holders were entitled to receive a 12% per annum preferred return on their initial investment, payable quarterly in arrears, had no equity appreciation ability and limited voting rights that were conditioned upon BHR’s default on the distribution of the 12% preferred return. The Series A Preferred Units contained certain embedded issuer call and holder put provisions, including the option of BHR to call and redeem all or any portion of the Series A Preferred Units for $50,000 per unit plus any accrued and unpaid preferred return at any time after the twelfth month of issuance. The holders of the Series A Preferred Units had a put right during three periods discussed below that, if exercised, required BHR to redeem 100% of the issued and outstanding Series A Preferred Units by making a payment equal to $50,000 per unit plus the accrued but unpaid preferred return. The holder was able to exercise the put right for a period of 30 days following the 36th month, 48th month and 60th month after the date of issuance. In the event of a sale of a property owned by BHR, the holders of the Series A Preferred Units were entitled to the repayment of their initial capital contribution plus any accrued and unpaid preferred return. We classified the Series A Preferred Units as noncontrolling interest as a part of mezzanine equity because the potential redemption is not within the complete control of BHR until the last put option period has expired. On April 15, 2014, BHR redeemed all 36.5 Series A Preferred Units for $1.8 million. These former holders of Series A Preferred Units used the proceeds from the redemption to purchase 143,017 shares of AAC common stock at $12.76 per share as part of an exempt common stock offering.

On April 15, 2014, BHR amended and restated its limited liability company agreement, which among other things, changed the rights and privileges of holders of Series A Preferred Units. In connection with this amendment and restatement, BHR received $7.8 million in net proceeds from the sale to BNY Alcentra Group Holdings, Inc. (“Alcentra”) of 160 new Series A Preferred Units. Alcentra received a 1% fee at closing and is entitled to receive a 12% per annum preferred return on its initial investment, payable quarterly in arrears. In the event of a non-payment, the preferred return compounds on a quarterly basis. In the event of non-payment for three months, the preferred return increases to 15.0%, and further increases to 18.0% if not paid beginning in the fourth month, with each increase compounding on a quarterly basis.

 

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The Series A Preferred Units contain certain embedded call and put provisions. BHR has the option to redeem a minimum of 40 Series A Preferred Units and up to 100% of the outstanding Series A Preferred Units for $50,000 per unit plus (i) any accrued and unpaid preferred return and (ii) a call premium of 3.0% through April 15, 2015, 2.0% from April 16, 2015 through April 15, 2017 and no premium any time after April 15, 2017. If an event of default occurs under the limited liability company agreement, the Series A Preferred Unit holders constituting a majority of such holders have the right to demand BHR to redeem all of the issued and outstanding Series A Preferred Units held by such holders equal to the sum of (i) such Series A Preferred Unit holder’s unrecovered capital contribution plus (ii) any accrued but unpaid preferred return. Alcentra may exercise its put right for a period of 30 days following the 36th month or 48th month after the date of issuance and at any time following the 60th month after the date of issuance. In the event of a sale of a property owned by BHR, Alcentra is entitled to the repayment of its initial capital contribution plus (i) any accrued and unpaid preferred return and (ii) any applicable call premium. As long as Alcentra owns at least 60 Series A Preferred Units less any Series A Preferred Units repurchased by BHR, distributions to affiliates of BHR are limited to $3.0 million annually.

The Series A Preferred Units generally have no voting or approval rights regarding the management of BHR. However, the holders of Series A Preferred Units are entitled to vote with respect to (i) any action that would change the rights or restrictions of the Series A Preferred Units in a way that would adversely affect such holders and (ii) the creation or issuance of any other security convertible into or exercisable for any equity security of BHR having rights, preferences or privileges senior to the common units of BHR. In addition, unanimous approval of all BHR members, including the holders of Series A Preferred Units, is required to approve the sale by BHR of more than 50% of its real property, more than 50% of the voting or economic rights of any BHR subsidiary or the merger, consolidation, sale of all or substantially all of the assets of BHR or sale of a majority of the common units of BHR.

In addition, so long as Alcentra owns at least 60 Series A Preferred Units, subject to adjustment for certain BHR redemptions, the manager of BHR may not engage in certain transactions without the approval of a majority of the Series A Preferred Unit holders, including, without limitation, the following: (i) liquidate, dissolve or wind up the business of BHR; (ii) authorize the issuance of additional Series A Preferred Units or any class or series of equity securities with rights, preferences or parity with or senior to that of the Series A Preferred Units; (iii) declare or pay any cash distribution or make any other distribution not permitted under the limited liability company agreement; (iv) pay any management or similar fees; (v) pay rebates or reduce payments payable by any primary tenants; or (vi) make payments to affiliates of BHR in excess of $3.0 million per year in the aggregate.

Related Party Notes Payable

In April 2013, a related party subordinated note with our CEO in the amount of $1.5 million was converted into 182,260 shares of AAC common stock, and a portion of debt outstanding under a related party subordinated note to one of the sellers of the TSN Acquisition in the amount of $0.5 million was converted into 60,753 shares of AAC common stock.

In August 2012, we entered into notes payable with two significant stockholders, resulting from seller financing of the TSN Acquisition. Interest rates on these notes are 3.125% and 5.0%, and the notes mature on August 31, 2015. The aggregate amount outstanding on these borrowings at June 30, 2014 was $4.0 million.

In April 2011, we entered into an agreement with a former director and stockholder for the repurchase of common and preferred shares held by such party. Under the terms of the agreement, we issued a $0.6 million subordinated note to the stockholder and agreed to make other payments totaling $0.2 million to or on behalf of the stockholder in exchange for 526,247 shares of AAC common stock, 100,000 shares of Series B Preferred Stock and 656,586 shares of Series C Preferred Stock of Forterus, Inc. The balance of the note was fully paid in the second quarter of 2013.

For additional information concerning our related party notes payable, see “Certain Relationships and Related Party Transactions—AAC Related Party Debt” included elsewhere in this prospectus.

 

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Subordinated Promissory Notes (Related Party and Non-related Party)

In March 2012 through April 2012, we issued $1.0 million of subordinated promissory notes to certain accredited investors, of which $0.2 million was issued to one of our directors. The notes bear interest at 12% per annum. Interest is payable monthly and the principal amount is due, in full, on the applicable maturity date of the note. Notes in the principal amount of $0.2 million mature on March 31, 2015 and the remaining notes, in the principal amount of $0.8 million, mature on March 31, 2017. In connection with the issuance of these notes, we issued detachable warrants to the lenders to purchase 71,705 shares of AAC common stock at $1.00 per share. The warrants were exercisable at any time up to their expiration on March 31, 2022. We recorded a debt discount of $0.1 million related to the warrants which reduced the carrying value of the subordinated notes. As of June 30, 2014, the outstanding balance, net of the unamortized debt discount of $71,000, was $0.9 million, of which $0.2 million was due to one of our directors. In connection with the Reorganization Transactions, warrants representing 67,931 shares were exercised in March 2014 and the remaining warrants representing 3,774 shares were exercised in April 2014.

Various Third Party Notes Payable

We have various notes payable with third-party creditors primarily for the purchase of vehicles, furniture and office equipment. The outstanding notes have maturity dates ranging from September 2014 to November 2017 and interest rates ranging from 0.0% to 12.3% per annum. Aggregate monthly payments range from $200 to $16,250. As of June 30, 2014, the aggregate balance on these notes was $1.0 million.

Capital Lease Obligations

During 2013 and the first half of 2014, we entered into capital leases with third party leasing companies for equipment and office furniture. The capital leases bear interest at rates ranging from 4.0% to 5.2% and have maturity dates from November 2015 through March 2019. Total obligations under capital leases at June 30, 2014 were $1.1 million of which $0.3 million was included in the current portion of long-term debt.

Consolidation of VIEs

Based on our guarantees of certain entities’ debt and our ability to direct the activities that most significantly impact the financial results of such entities, we began consolidating Concorde Real Estate, LLC on June 27, 2012 and Greenhouse Real Estate, LLC on October 8, 2013. In addition, we included The Academy Real Estate, LLC in historical financial results from May 2013 to December 10, 2013, at which time we sold our membership interests in The Academy Real Estate, LLC to BHR and consolidated it as a VIE through April 15, 2014 when BHR was acquired and became a wholly owned subsidiary of the Company.

We are affiliated with a professional group in each of the five states in which we operate (the “Professional Groups”). These Professional Groups engage physicians and mid-level service providers and provide professional services to our clients through professional services agreements with each treatment facility. Under the professional services agreements, the Professional Groups also provide a physician to serve as medical director for the applicable facility. The Professional Groups either bill the payor for their services directly or are compensated by the treatment facility based on fair market value hourly rates. Each of the professional services agreements has a term of five years and will automatically renew for additional one-year periods. For additional information related to the Professional Groups, see Note 5 to our audited financial statements included elsewhere in this prospectus.

We provided the initial working capital funding in connection with the formation of the Professional Groups in return for a receivable. We make additional advances to the Professional Groups during periods in which there is a shortfall between revenues collected by the Professional Groups from the treatment facilities and payors, on the one hand, and the Professional Group’s contracting expenses and payroll requirements, on the other hand, thereby increasing the balance of the receivable. Excess cash flow of the Professional Groups is repaid to us, resulting in a decrease in the receivable. The Professional Groups are obligated to repay these funds

 

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and are charged commercially reasonable interest. We had a receivable from each of the Professional Groups at June 30, 2014. The receivables due to us from the Professional Groups are eliminated in the consolidation of the Professional Groups as VIEs.

AAC has entered into written management services agreements with each of the Professional Groups under which AAC provides management and other administrative services to the Professional Groups. These services include billing, collection of accounts receivable, accounting, management and human resource functions and setting policies and procedures. Pursuant to the management services agreements, the Professional Groups’ monthly revenues will first be applied to the payment of operating expenses consisting of refunds or rebates owed to clients or payors, compensation expenses of the physicians and other service providers, lease payments, professional and liability insurance premiums and any other costs or expenses incurred by AAC for the benefit of the Professional Groups and, thereafter, to the payment to AAC of a management fee equal to 20% of the Professional Groups’ gross collected monthly revenues. As described above, AAC will also provide financial support to each Professional Group on an as-needed basis to cover any shortfall between revenues collected by such Professional Groups from the treatment facilities and payors and the Professional Group’s contracting expenses and payroll requirements. Through these arrangements, we are directing the activities that most significantly impact the financial results of the respective Professional Groups; however, treatment decisions are made solely by licensed healthcare professionals employed or engaged by the Professional Groups as required by various state laws. Based on our ability to direct the activities that most significantly impact the financial results of the Professional Groups, provide necessary funding and the obligation and likelihood of absorbing all expected gains and losses, we have determined that we are the primary beneficiary, and, therefore, consolidate the five Professional Groups as variable interest entities.

Off Balance Sheet Arrangements

We have entered into various non-cancelable operating leases expiring through October 2018. Commercial properties under operating leases primarily include space required to perform client services and space for administrative facilities. Rent expense was $4.6 million and $3.6 million for the years ended December 31, 2013 and 2012, respectively, and $1.0 million and $3.0 million for the six months ended June 30, 2014 and 2013, respectively. Included in such amounts were payments made to related parties totaling $1.3 million and $1.2 million for the years ended December 31, 2013 and 2012, respectively, and $0.5 million for the six months ended June 30, 2013. With the consolidation of Greenhouse Real Estate, LLC as a variable interest entity in October 2013, we no longer have lease expense to related parties after such date.

Contractual Obligations

The following table sets forth information regarding our contractual obligations as of December 31, 2013:

 

     Payments due by period:  
     (in thousands)  
            Less than     1 to 3      3 to 5      More than  
     Total      1 year     years      years      5 years  

Contractual Obligations (1)

             

Term loans

   $ 7,435       $ 2,902      $ 4,427       $ 106       $   

Revolving line of credit

     12,550                12,550                   

Subordinated debt

     863                141         722           

Consolidated BHR debt

     21,548         12,932 (5)       1,278         7,338           

Interest (2)

     3,385         1,295        1,329         634         127   

Capital lease obligations (3)

     1,112         338        584         190           

Operating lease obligations

     2,779         1,126        1,438         215           

Litigation settlement

     2,588         2,588                          

Other contractual obligations (4)

     23,168         5,047        2,877         2,880         12,364   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

 

Total

   $ 75,428       $ 26,228 (5)     $ 24,624       $ 12,085       $ 12,791   
  

 

 

    

 

 

   

 

 

    

 

 

    

 

 

 

 

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(1) For information related to the effects of this offering on our contractual obligations, including to our term loans, revolving line of credit and interest expense, see “Unaudited Pro Forma Consolidated Financial Statements” included elsewhere in this prospectus.

(2) Interest includes the estimated interest payments under our borrowing agreements assuming no change in LIBOR as of December 31, 2013. In August 2014, we converted the Greenhouse Loan to a permanent term loan that amortizes over five years and has an interest rate of 4.62%, after considering the impact of the interest rate swap agreement as of August 12, 2014. Interest payments for the permanent term loan will total $0.4 million, $0.9 million and $0.4 for the periods “Less than 1 year,” “1 to 3 years” and “3 to 5 years” in the above table, respectively, for total interest of $1.7 million.

(3) Includes principal and interest.

(4) Represents estimated payments (including interest) associated with (i) the acquisition, development, and financing of properties under contract located in Arlington, Texas ($1.6 million) and Las Vegas, Nevada ($2.8 million), (ii) the remaining construction commitments for the Greenhouse facility expansion ($4.5 million) and (iii) the development of the facility in Riverview, Florida ($13.4 million). Excludes payments related to the acquisition of the property in Ringwood, New Jersey for $6.5 million, as certain conditions precedent under the purchase agreement have not been satisfied. These future payments reflect management’s best estimates of budgeted construction costs and financing arrangements under current market conditions, and as such, actual costs and timing could vary.

(5) Includes $8.7 million principal outstanding under the Greenhouse Loan. In August 2014, we converted the Greenhouse Loan to a permanent term loan with a principal balance of $12.7 million that amortizes over five years and matures in August 2019. For additional information related to this conversion, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Financing Relationships—BHR Debt” included elsewhere in this prospectus.

As of June 30, 2014, our contractual obligations decreased by approximately $3.0 million primarily from our purchase of the Arlington, Texas and Las Vegas, Nevada properties in March 2014 and May 2014, respectively.

Quantitative and Qualitative Disclosures About Market Risk

Our interest expense is sensitive to changes in market interest rates. With respect to our interest-bearing liabilities, our long-term debt outstanding at June 30, 2014 consisted of $38.7 million of variable rate debt with interest based on LIBOR plus an applicable margin. A hypothetical 1% increase in interest rates would decrease our pre-tax income and cash flows by approximately $387,000 on an annual basis based upon our borrowing level at June 30, 2014.

Subsequent to June 30, 2014, we entered into interest rate swap agreements to manage our exposure to fluctuations in interest rates. After taking into account the interest rate swap agreements, our interest-bearing liabilities on our long-term debt outstanding at June 30, 2014 consists of $16.6 million of variable rate debt with interest based on LIBOR plus an applicable margin. A hypothetical 1% increase in interest rates would decrease our pre-tax income and cash flows by approximately $166,000 on an annual basis based upon our borrowing level at June 30, 2014.

Critical Accounting Policies

Our consolidated financial statements have been prepared in accordance with GAAP. In preparing our consolidated financial statements, we are required to make certain estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses included in the financial statements. Estimates are based on historical experience and other available information, the results of which form the basis of such estimates. While we believe our estimation processes are reasonable, actual results could differ from our estimates. The following accounting policies are considered critical to our operating performance and involve subjective and complex assumptions and assessments.

Revenue Recognition

We provide services to our clients in both inpatient and outpatient treatment settings. Revenues are recognized when services are performed at the estimated net realizable value amount from clients, third-party payors and others for services provided. We receive the vast majority of payments from commercial payors at out-of-network rates. Client service revenues are recorded at established billing rates less adjustments to estimate net realizable value. Adjustments are recorded to state client service revenues at the amount expected to be collected for the service provided based on historic adjustments for out-of-network services not under contract. Provisions for estimated third party payor reimbursements are provided in the period related services rendered and adjusted in future periods when actual periods are received.

 

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Prior to admission, insurance coverage, as applicable, is verified and the client self-pay amount is determined. The client self-pay portion is generally collected upon admission. In some instances, clients will pay out-of-pocket as services are provided or will make a deposit and negotiate the remaining payments as part of the services. These out-of-pocket payments are included in accrued liabilities in the accompanying consolidated balance sheets and revenues related to these payments are deferred and recognized over the period services are provided. We do not recognize revenue for any amounts not collected from the client. From time to time we may provide scholarships to a limited number of clients. We do not recognize revenues for scholarships provided.

We recognize revenues from commercial payors at the time services are provided based on our estimate of the amount that payors will pay us for the services performed. We estimate the net realizable value of revenues by adjusting gross client charges using our expected realization and applying this discount to gross client charges. Through December 31, 2013, our expected realization was determined by management after taking into account historical collections received from the commercial payors since our inception compared to the gross client charges billed. Beginning in January 2014, we enhanced the methodology related to our net realizable value to more quickly react to potential changes in reimbursements by facility, by type of service and by payor. As a result, management adjusted the expected realization discount, on a per facility basis, to reflect a twelve-month historical analysis of reimbursement data by facility in addition to considering the type of services provided, the payors and the gross client charge rates by facility. This change resulted in a decrease in our expected realization for the first six months of 2014.

Estimates of net realizable value are subject to significant judgment and approximation by management. It is possible that actual results could differ from the historical estimates management has used to help determine the net realizable value of revenues. If our actual collections either exceed or are less than the net realizable value estimates, we will record a revenue adjustment, either positive or negative, for the difference between our estimate of the receivable and the amount actually collected in the reporting period in which the collection occurred.

In cases where the demand for our services exceeds our capacity, we have entered into contractual arrangements with other parties to provide corporate support services. Based on criteria outlined in ASC 605, Revenue Recognition , management determined that we are the principal party to the corporate support services provided. As a result, revenues generated through our contractual arrangements are included in revenues at their expected realizable amount while the subcontracted service payments made to the subcontracted parties are included in client expenses. The need for these contractual arrangements decreased as we increased bed capacity in the second half of 2012 and in the first half of 2013 as a result of the opening of the Desert Hope facility.

Allowance for Contractual and Other Discounts

We derive the vast majority of our revenue reimbursements from commercial payors at out-of-network rates. Management estimates the allowance for contractual and other discounts based on its historical collections experience. The services authorized and provided and related reimbursement are often subject to interpretation and negotiation that could result in payments that differ from our estimates.

Allowance for Doubtful Accounts

Accounts receivable primarily consist of amounts due from third-party commercial payors and clients and we record accounts receivable net of contractual discounts. Our ability to collect outstanding receivables is critical to our results of operations and cash flows. Accounts receivable are reported net of an allowance for doubtful accounts, which is management’s best estimate of accounts receivable that could become uncollectible in the future. Accordingly, the accounts receivable reported in our consolidated financial statements are recorded at the net amount expected to be received. Our primary collection risks are (i) the risk of overestimating our net revenues at the time of billing that may result in us receiving less than the recorded receivable, (ii) the risk of non-payment as a result of commercial insurance companies denying claims, (iii) the risk that clients will fail to remit insurance payments to us when the commercial insurance company pays out-of-network claims directly to the client, (iv) resource and capacity constraints that may prevent us from handling the volume of billing and collection issues in a timely manner and (v) the risk of non-payment from uninsured clients. In evaluating the

 

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collectability of accounts receivable and evaluating the adequacy of our allowance for doubtful accounts, management considers a number of factors, including historical experience, the age of the accounts and current economic trends. We continually monitor our accounts receivable balances and utilize retrospective reviews and cash collection data to support our estimates of the allowance for doubtful accounts. In the second quarter of 2014, we analyzed our recent collection experience and made adjustments to the calculation of the net realizable value of our accounts receivable to take into account our collections experience over the past two years and improvements in the credit quality of our aged receivables. Estimates of our allowance for doubtful accounts are determined on a quarterly basis and adjusted monthly thereafter based on actual collections. If actual future collections are less favorable than those projected by management, additional allowances for uncollectible accounts may be required. There can be no guarantee that we will continue to experience the same collection rates that we have experienced in the past. We do not believe that there are any significant concentrations of revenues from any particular payor that would subject us to significant credit risks in the event a payor becomes unwilling or unable to pay claims.

Goodwill and Intangible Assets

Goodwill represents the excess of the purchase price over the fair value of the identifiable net assets acquired. Goodwill and intangible assets with indefinite lives are not amortized, but instead tested for impairment at least annually or whenever events or changes in circumstances indicate the carrying value may not be recoverable. We have no intangible assets with indefinite useful lives other than goodwill. We consider the following to be important factors that could trigger an impairment review: significant underperformance relative to historical or projected future operating results; identification of other impaired assets within a reporting unit; significant adverse changes in business climate or regulations; significant changes in senior management; significant changes in the manner of use of the acquired assets or the strategy for our overall business; and significant negative industry or economic trends.

Goodwill is assessed for impairment using a fair value approach at the reporting unit level. The goodwill impairment test is a two-step process, if necessary. The provisions for the accounting standard of goodwill provide an entity with the option to assess qualitative factors to determine whether the existence of events or circumstances leads to the determination that it is more likely than not that the fair value of a reporting unit is less than its carrying amount. This qualitative assessment is referred to as a “step zero” approach. If, based on the qualitative factors, an entity determines it is not more likely than not that the fair value of a reporting unit is less than its carrying value, the entity may skip the two-step impairment test required by accounting guidance. If an entity determines otherwise or, at the option of the entity, if a step zero is not performed, step one of the two-step impairment test is required. Under step one, the fair value of the reporting unit is compared with its carrying value (including goodwill). If the fair value of the reporting unit is less than its carrying value, an indication of goodwill impairment exists for the reporting unit and the entity must perform step two of the impairment test (measurement). Under step two, an impairment loss is recognized for any excess of the carrying amount of the reporting unit’s goodwill over the implied fair value of that goodwill. The implied fair value of goodwill is determined by allocating the fair value of the reporting unit in a manner similar to a purchase price allocation and the residual fair value after this allocation is the implied fair value of the reporting unit goodwill. Fair value of the reporting unit is determined using a discounted cash flow analysis. If the fair value of the reporting unit exceeds its carrying value, step two does not need to be performed. Impairment shall be recognized to the extent that the carrying amount of goodwill exceeds its implied fair value. In performing step one of the goodwill impairment test, we compare the carrying amount of the reporting unit to the estimated fair value.

In assessing the recoverability of goodwill, we consider historical results, current operating trends and results, and make estimates and assumptions about revenues, margins and discount rates based on our budgets, business plans, economic projections and anticipated future cash flows. Each of these factors contains inherent uncertainties, and management exercises substantial judgment and discretion in evaluating and applying these factors.

 

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The annual goodwill impairment test is performed as of December 31 of each year, utilizing the two-step test. We concluded that the carrying value of the reporting unit as of December 31, 2013 did not exceed its fair value, and thus no indication of impairment was present. The fair value of goodwill exceeded the carrying value by $3.3 million at December 31, 2013.

Long-Lived Assets and Intangible Assets Subject to Amortization

Long-lived and intangible assets subject to amortization are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net undiscounted cash flows expected to be generated by the asset. Impairment is measured by the amount by which the carrying value of the assets exceeds the fair value of the assets.

Accounting for Income Taxes

We account for income taxes in accordance with ASC 740, Income Taxes . Under the asset and liability method of ASC 740, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled.

Under ASC 740, the effect on the deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. A valuation allowance is provided for significant deferred tax assets when it is more likely than not that such assets will not be recovered.

Our practice is to recognize interest and/or penalties related to income tax matters in income tax expense.

Stock-Based Compensation Expense

We measure compensation expense for all stock-based awards at fair value on the date of grant and recognize compensation expense over the service period for the awards expected to vest. Since December 2012, we have obtained periodic valuation analyses prepared by independent third-party valuation firms to assist us with the determination of the fair value of our common stock.

These estimations of fair value are not indicative of future performance and will not be necessary to determine the fair value of new awards after the underlying shares trade on a liquid market.

December 2012 Valuation

We determined the fair value of AAC’s common stock to be $8.23 as of December 15, 2012. In determining the fair value of AAC’s common stock we reviewed an independent third party valuation report, which used a discounted cash flow method applying a discount rate of 17.6%. Other factors considered in our valuation were the TSN Acquisition in August 2012, which provided an indication of a recent value established as a result of negotiation between sophisticated parties with substantial due diligence about both parties, and a market transaction announced in November 2012 involving similar behavioral health companies. Based on the foregoing analysis, the fair value of the December 31, 2012 grants of 170,517 shares of AAC common stock and 85,078 shares of restricted AAC common stock were determined to be $8.23 per share.

November 2013 Valuation

On November 19, 2013, AAC issued 92,815 shares of restricted AAC common stock to three employees under our 2007 Stock Incentive Plan, or the 2007 Plan, of which 23,203 shares were immediately vested and the

 

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remaining 69,612 shares vest ratably over each quarter ending March 31, 2014 through September 30, 2014. The valuation of AAC’s common stock was determined in accordance with the guidelines outlined in the American Institute of Certified Public Accounts Practice Aid, Calculation of Privately-Held Company Equity Securities Issued as Compensation . We engaged a third party valuation firm to construct a probability-weighted expected return model (“PWERM”) and to assist and advise management in determining the appropriate inputs and metrics to the model. Because there was no public market for AAC’s common stock, the board of directors, with input from management, exercised significant judgment and considered numerous objective and subjective factors to determine the fair value of AAC’s common stock as of November 14, 2013, including the following factors:

 

    previous third party valuations of AAC’s common stock;

 

    the price of AAC’s common stock sold to third-party investors;

 

    the value of AAC’s common stock issued in the TSN Acquisition in August 2012;

 

    a market transaction announced in November 2012 involving similar behavioral health companies;

 

    the valuation of a comparable public company;

 

    AAC’s operating and financial performance;

 

    current business conditions and projections;

 

    AAC’s stage of development;

 

    the likelihood of achieving a liquidity event for the shares of AAC’s common stock; such as an initial public offering or sale of AAC, given prevailing market conditions; and

 

    any adjustment necessary to recognize a lack of marketability for common stock.

We used PWERM in determining AAC’s equity value for the November 2013 grant. PWERM is an analysis of future values of a company for several likely liquidity scenarios that may include a strategic sale or merger, an initial public offering or the dissolution of a company, as well as a company’s enterprise value assuming the absence of a liquidity event. For each possible future event, the future values of the company are estimated at certain points in time. This future value is then discounted to a present value using an appropriate risk-adjusted discount rate. Then, a probability is estimated for each possible event based on the facts and circumstances as of the valuation date. Using PWERM, we estimated the value of AAC’s common stock based upon an analysis of varying values for AAC’s common stock assuming (i) the completion of an initial public offering, (ii) a merger or acquisition and (iii) the continuation as a private company. We applied a percentage probability weighting to each of these scenarios based on our expectations of the likelihood of each event. Based on the foregoing PWERM analysis, the fair value of the November 19, 2013 grants of 92,815 shares of restricted AAC common stock was determined to be $10.19 per share.

February 2014 Valuation

We determined the fair value of AAC’s common stock to be $12.76 as of February 12, 2014. In determining the fair value of AAC’s common stock, we reviewed a December 2013 independent third party valuation report, which determined AAC’s implied equity value using a discounted cash flow analysis, a comparison to a selection of precedent merger and acquisition transactions and a comparison to publicly-held companies. In addition, we considered the significant growth for EBITDA and revenues in 2013 compared to 2012, as well as the increased likelihood of an initial public offering of our common stock in 2014. We also considered projected results of operations for the first quarter of 2014 and positive revenue trends. Based on the foregoing analysis, the fair value of the shares of common stock issued in the private placement from February through April 2014, compensatory grants to each of our five non-employee directors in March 2014, a compensatory grant made to our recently hired General Counsel and Secretary in April 2014 under the 2007 Plan and a grant in April 2014 to a non-executive employee each were valued at $12.76 per share.

 

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April 2014 Valuation

In April 2014, Holdings issued an aggregate of 671,143 shares of common stock as consideration in connection with the BHR Acquisition and the CRMS Acquisition. In connection with these transactions, we determined the fair value of the shares of Holdings common stock issued in connection with the BHR Acquisition and the CRMS Acquisition to be $13.41 per share as of April 11, 2014. In addition to factoring in the prior valuation analyses described above, we also analyzed a new valuation report prepared by an independent third party with respect to the valuation of Holdings taking into account the Private Share Exchange, BHR Acquisition and CRMS Acquisition. In particular, the valuation report analyzed the potential impact of the then-proposed Reorganization Transactions on the valuation of Holdings, such as the increase in 2013 pro forma net income as a result of BHR results of operations being included for all of 2013. The valuation report also noted that the impact of the BHR Acquisition on the enterprise value would be mixed, as the additional EBITDA generated at the Holdings level due to the recapture of rents and cash and non-cash expenses was not sufficient to overcome the negative impact on enterprise value of BHR’s debt outstanding for the entire year. With respect to CRMS, the analysis determined that it would allow the recapture of additional EBITDA (on a pro forma basis for 2013) due to a combination of recaptured revenues (i.e., commissions no longer paid) and the expected cost savings. In determining the fair value of our common stock, we also considered the improved projected results of operations for the remainder of 2014, positive revenue trends, strong investor demand in the 2014 private placement by AAC and the higher probability of an initial public offering in 2014. Based on the foregoing analysis, we determined the fair value of Holdings common stock as of April 11, 2014 to be $13.41 per share.

Emerging Growth Company Status

Section 107 of the Jumpstart Our Business Startups Act, or JOBS Act, provides that an “emerging growth company” can take advantage of the extended transition period afforded by the JOBS Act for the implementation of new or revised accounting standards. However, we are choosing to “opt out” of such extended transition period, and as a result, we will comply with new or revised accounting standards on the relevant dates on which adoption of such standards is required for non-emerging growth companies. Section 107 of the JOBS Act provides that our decision to not take advantage of the extended transition period for complying with new or revised accounting standards is irrevocable.

Recently Issued But Not Yet Effective Accounting Pronouncements

In May 2014, the FASB issued ASU No. 2014-09 Revenue from Contracts with Customers (Topic 606), which supersedes the revenue recognition requirements in ASC 605 (Revenue Recognition) . This ASU is based on the principle that revenue is recognized to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those good or services. The ASU also requires additional disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments and assets recognized from costs incurred to obtain or fulfill a contract. The effective date of this ASU will be for annual reporting periods beginning after December 15, 2016 using one of two retrospective application methods, and early application is not permitted. The Company is currently evaluating the estimated impact of the adoption of this accounting standard update on its financial statements.

 

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BUSINESS

Company Overview

We believe we are a leading provider of inpatient substance abuse treatment services for individuals with drug and alcohol addiction. As of July 31, 2014, we operated six substance abuse treatment facilities located throughout the United States, focused on delivering effective clinical care and treatment solutions across our 467 beds, which included 338 licensed detoxification beds. In addition, we have three facilities under development and an additional property under contract that we plan to develop into a new facility. The majority of our 715 employees are highly trained clinical staff who deploy research-based treatment programs with structured curricula for detoxification, residential treatment, partial hospitalization and intensive outpatient care. By applying a tailored treatment program based on the individual needs of each client, many of whom require treatment for a co-occurring mental health disorder, such as depression, bipolar disorder and schizophrenia, we believe we offer the level of quality care and service necessary for our clients to achieve and maintain sobriety.

We have made substantial investments in our treatment facilities with a specific focus on providing aesthetically pleasing properties and grounds, numerous amenities, healthy food and a courteous and attentive staff to distinguish us from our competitors. Our commitment to clinical excellence, premium facilities and customer service has allowed us to form relationships across a broad set of key referral sources, including hospitals, other treatment facilities, employers, alumni and employee assistance programs. Our platform is supported by a centralized infrastructure that includes a multi-faceted sales and marketing program, call center operations, a laboratory facility, billing and collection services and support functions. This infrastructure, in conjunction with our premium service offerings, has enabled us to develop a strong national brand. The substantial investments we have made at a corporate level contribute to our operational efficiencies and provide us flexibility to place clients at a variety of our facilities in order to optimize care that best fits both the clients’ clinical needs and their insurance benefits.

We have demonstrated the ability to grow our business organically and generate attractive returns on investments with our de novo development capabilities. Our two de novo developments, Greenhouse and Desert Hope, added 218 total beds on a combined basis, and each achieved profitability within the first year of its respective opening. Our net revenues have increased to $115.7 million in 2013 from $66.0 million in 2012, representing a growth rate of 75.3%. In addition, for the years ended December 31, 2013 and December 31, 2012, we had $11.6 million and $7.2 million in Adjusted EBITDA and $1.5 million and $1.1 million in net income, respectively. In 2013 and for the six months ended June 30, 2014, approximately 90% of our revenues were reimbursable by commercial payors, including amounts paid by such payors to clients, and the remaining portion was payable directly by our clients. We currently do not receive any revenues from government healthcare payment programs such as Medicare and Medicaid. See “Selected Historical and Pro Forma Consolidated Financial and Operating Data” for a discussion of Adjusted EBITDA and a reconciliation of Adjusted EBITDA to net income, the most directly comparable GAAP measure.

Industry Overview

Addiction is a chronic disease that affects brain function and behavior. Substance abuse, specifically the abuse of drugs and alcohol, is one of the most common and serious forms of addiction. If left untreated, substance abuse can lead to a variety of destructive social conditions such as problems at home or work, violence, crime and even death. According to the National Institute on Drug Abuse, or NIDA, the total societal cost of substance abuse in the United States is estimated to be over $600 billion annually. The 2012 National Survey on Drug Use and Health estimates that approximately 23.1 million people aged 12 or older needed treatment for a drug or alcohol use problem in the United States in 2012, of which only 2.5 million, or 10.8% of those needing

 

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treatment, received treatment at a specialty facility. According to a 2008 report by the Substance Abuse and Mental Health Services Administration, or SAMHSA, annual spending on treatment for substance abuse in the United States is expected to grow to $35 billion in 2014.

The National Comorbidity Survey reports that up to 65% of adults with substance abuse addiction also have a co-occurring mental health disorder, defined by SAMHSA as at least one major mental health disorder, such as depression, bipolar disorder and schizophrenia, occurring concurrently with substance abuse. The industry’s focus on diagnosing and treating the primary substance abuse addiction without attempting to uncover a potential mental health disorder can mask the high occurrence of clients with a co-occurring mental health disorder, a highly underserved segment of the mental illness and substance abuse treatment market. According to the President’s New Freedom Commission on Mental Health, only 19% of those who have co-occurring disorders receive treatment for both disorders, and 29% do not receive treatment for either problem. According to the Disease Management and Health Outcomes Journal, integrating treatment for both substance abuse and a co-occurring mental health disorder is believed to result in significantly better outcomes.

The substance abuse treatment industry is highly fragmented and largely consists of small regional operators. We estimate, based on IBISWorld estimates, that there were more than 16,700 individual mental health and substance abuse treatment clinics and centers in the United States in 2013, operated by over 8,100 enterprises, 67% of which were not-for-profits. An estimated 44% of these enterprises have fewer than 20 employees and over 45% operate a single facility. According to SAMHSA’s 2011 annual census of facilities providing substance abuse treatment, approximately 59% of facilities listed substance abuse treatment as the primary focus of their activities, but only 32% of facilities indicated that a mix of mental health and substance abuse treatment services were their primary focus. The majority of facilities in the United States do not offer residential treatment with only 26% of facilities responding to SAMHSA as offering these inpatient services.

The mental health and substance abuse treatment industry is expected to continue to expand as a result of a combination of factors, including increased awareness and de-stigmatization of substance abuse treatment and mental health disorders as more people seek treatment, favorable healthcare legislation and an expanding population. Recent healthcare reform is expected to enable greater access to treatment and services as more people obtain insurance coverage and the scope of coverage is expanded. As a result of the Affordable Care Act, healthcare reform is projected to expand coverage to approximately 25 million currently uninsured people by 2016 according to the Congressional Budget Office. According to the Employee Benefit Research Institute, this includes an estimated 3.1 million young adults who will have coverage as a result of the Adult-Dependent Mandate, which ensures that children under the age of 26 can stay on a parent’s plan. The Mental Health Parity and Addiction Equity Act of 2008, or MHPAEA, is federal legislation that provides for equal coverage between psychiatric or mental health services and conventional medical health services and restricts employers and insurers from placing more stringent limits on mental healthcare compared to other health conditions. According to the U.S. Department of Labor, the MHPAEA has already brought about coverage changes for approximately 103 million individuals, suggesting more comprehensive behavioral insurance coverage benefits for a significant number of individuals in the United States.

In addition to strong industry growth dynamics, the substance abuse treatment sector has several favorable attributes that differentiate it from other healthcare services sectors. Of particular note, as a result of the nature of substance abuse treatment, clients have more control in deciding when to seek treatment and who to select as their treatment provider. Placing a client in an inpatient treatment center can help remove many of the factors that contribute to substance abuse (e.g. access to dealers, negative influences, emotional triggers) and enable clients to better focus on their recovery. Also, clients are typically not limited to their local geographic area in selecting a treatment facility. As a result, providers are able to market and advertise directly to potential clients and their families on a national level.

 

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Substance abuse addiction is a complex, chronic disease. Research from the NIDA shows that treatment programs tailored to each individual’s drug abuse patterns and any co-occurring mental health disorders can lead to sustained recovery periods. Below are examples of treatment programs at various levels of care according to the American Society of Addiction Medicine:

 

    Detoxification – Inpatient care with clients medically monitored 24 hours per day, seven days per week by medical professionals who work to alleviate withdrawal symptoms through medication, as appropriate;

 

    Residential Treatment – Inpatient care provided 24 hours per day, seven days per week, generally including two individual therapy sessions per week and regular group therapy with appropriate medical and psychiatric care provided, as needed;

 

    Partial Hospitalization – Inpatient care provided in a structured program at least five days a week for no fewer than six hours a day, including a minimum of weekly individual therapy and regular group therapy with appropriate medical and psychiatric care provided, as needed;

 

    Intensive Outpatient – Outpatient care provided three days per week for three hours per day at a minimum, including weekly individual therapy and group therapy; and

 

    Outpatient Counseling – Outpatient sessions conducted in individual or group sessions on an as needed basis.

Our Competitive Strengths

We believe the following strengths differentiate us from our competitors and will allow us to successfully operate and grow our business:

 

    Leading substance abuse treatment platform. We believe we are a leading provider of substance abuse treatment services based on the scale and nationwide reach of our platform, quality of our facilities and breadth of our treatment capabilities. With 467 total beds across six substance abuse treatment facilities, we believe we offer one of the largest for-profit fully licensed programs to treat drug and alcohol addiction regardless of stage or severity. Our premium facilities offer clients aesthetically pleasing properties and grounds, a comfortable environment, high quality and healthy food, numerous amenities and a courteous and attentive staff. We believe our commitment to quality and customer service, as well as our dedication to clinical excellence, results in improved client retention, an important factor in ensuring clients receive the care they need. The combination of these attributes has allowed us to form relationships with key referral sources in the industry, including hospitals, other treatment facilities, employers, alumni and employee assistance programs, further strengthening our competitive position and national brand.

 

    Comprehensive addiction treatment programs with co-occurring mental health disorder treatment capabilities. Our clinical staff is trained to deploy a research-based treatment program with a structured curriculum, particularly focused on identifying and addressing the needs of clients with co-occurring mental health disorders. We address a broad set of client needs through our comprehensive clinical programs that include detoxification, residential treatment, partial hospitalization and intensive outpatient care. Given that up to 65% of adults with substance abuse addiction are estimated to also have at least one co-occurring mental health disorder, we believe our medical and clinical staff’s ability to identify and treat both disorders is critical in helping clients achieve sobriety. Due to the complexity of their cases, clients with co-occurring mental health disorders often require more intensive treatment. We believe our ability to address these complex conditions enhances our reputation with clients, their families and other referral sources.

 

   

Proven ability to develop de novo treatment facilities. We have a successful track record of identifying suitable de novo sites, securing properties, overseeing the licensing and development of facilities and integrating de novo centers into our broader platform. We have successfully transformed acquired properties, such as a luxury spa and an assisted living facility, into substance abuse treatment facilities.

 

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We believe our skill and experience in executing our de novo development strategy provides us with a competitive advantage in quickly and cost-effectively developing substance abuse treatment facilities and enrolling clients. Our two de novo facilities, Greenhouse and Desert Hope, opened within 12 months of initially acquiring each respective property, and both were profitable within their first year of operation. We believe this is particularly noteworthy given the relative size of the facilities developed. With 148 beds, we believe Desert Hope is one of the largest premium residential substance abuse treatment facilities in the United States today. By focusing on larger facilities, we have the scale to offer a level of treatment services and amenities that otherwise would be cost prohibitive, namely our ability to house an onsite pharmacy and facilitate comprehensive medical services via onsite nurses, nurse practitioners and physicians.

 

    Multi-faceted sales and marketing program. Our national sales and marketing program provides a competitive advantage compared to treatment facilities that primarily target local geographic areas and use fewer marketing channels to attract clients. Our national team of 36 professional sales representatives develops and maintains relationships with key referral sources such as hospitals, other treatment facilities, employers, alumni and employee assistance programs. In addition, our team of over 60 centralized, trained call center treatment consultants provides coverage and support 24 hours a day, seven days a week. Our coordinated approach to leveraging our sales team, relationships in the industry, internet, television and print advertising and potential client inquiries and our ability to serve clients from our varied facilities across the United States allows us to reach a broad audience of potential clients and build a nationally recognized brand. Given our multi-faceted sales and marketing program, we have been able to attract clients from a diverse set of channels. This nationally branded, multi-channel approach has led to an increase in our number of admitted clients from 2,934 in 2012 to 4,027 in 2013, a 37.3% growth rate. Our investment in a dedicated call center and supporting technology allows us to evaluate the effectiveness of our various marketing channels. Analyzing this information enables us to adjust sales and marketing efforts to address near-term census levels across our facilities and optimize our spending on sales and marketing.

 

    Attractive payor mix and diversified client base. We have generated revenues solely from commercial payors and our clients with no reimbursement from government healthcare payment programs such as Medicare and Medicaid, which are typically subject to lower reimbursement rates. The relationships we have developed with our referral sources enhance our interactions with payors and help us achieve our attractive reimbursement profile. For the year ended December 31, 2013 and the six months ended June 30, 2014, approximately 90% of our revenues were reimbursable by commercial payors, including amounts paid by such payors to clients, with the remaining portion of our revenues payable directly by our clients. No single payor in 2013 or the first half of 2014 accounted for more than 12.3% and 14.5% of our revenue reimbursements, respectively.

 

    Strong financial performance and attractive returns on invested capital. We have achieved strong financial performance in terms of recent growth and profitability. Our revenues for the year ended December 31, 2013 were $115.7 million, representing a 75.3% increase over $66.0 million in 2012. We believe the profitability and modest capital needs of our established substance abuse treatment facilities position us to generate strong cash flows. We have demonstrated the ability to generate attractive returns on investment with our de novo development strategy. Each of our two de novo developments, Greenhouse and Desert Hope, which added 218 total beds on a combined basis, was profitable within its first year of operation.

 

   

Experienced management team with track record of success. Our senior management team, with an average of over 15 years of experience in the healthcare industry, has significant experience developing, operating and growing a variety of behavioral health treatment facilities. During our Chief Executive Officer’s nearly 20 year career in the substance abuse treatment industry, he developed two not-for-profit treatment companies before founding and developing a for-profit substance abuse treatment company with multiple operations in California and Tennessee. Our President has spent almost 18 years in the behavioral health industry, also focused on developing de novo substance abuse treatment

 

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facilities, including one of our predecessor companies. In addition, our Chief Operating Officer brings 22 years of experience in various senior roles at a leading provider of treatment and educational programs for adults and youth struggling with behavioral issues. We believe the combination of our management team’s skills and experiences provides us with an advantage in developing high quality de novo treatment facilities and quickly integrating them into our broader platform. Our senior management team is committed to utilizing its extensive experience in the execution of our long-term strategic plan.

Our Growth Strategy

We have developed our company and the American Addiction Centers national brand through substantial investment in our facilities, our clinical expertise, our professional staff and our national sales and marketing program. We anticipate a number of factors will accelerate demand for our services, including increased awareness and de-stigmatization of substance abuse treatment and recent healthcare reform improving access to care, particularly for young adults now able to access their parents’ insurance. We seek to extend our position as a leading provider of treatment for drug and alcohol addiction by executing the following growth strategies:

 

    Improve census at existing facilities. We seek to improve census and client demand by increasing our client leads through our multi-faceted sales and marketing program, consisting of our national sales team, recommendations from alumni and healthcare professionals, internet, television and print advertising and potential client inquiries. By utilizing multiple sales and marketing channels, we generate significant inbound call volume from potential clients and the people close to them, and our consultative call center approach enables us to effectively identify and enroll qualified clients.

 

    Expand capacity at existing residential facilities. As our client demand increases, we seek opportunities to expand capacity at our existing facilities. When market conditions indicate, we anticipate selectively increasing our number of residential beds, expanding our clinical facility space and hiring additional clinical staff to enable us to provide services to additional clients. Construction of the expansion of our Greenhouse location from 70 beds to 130 beds was completed in July 2014, and we received licensure for the additional beds in July 2014.

 

    Pursue de novo development of residential facilities. We currently operate six residential substance abuse treatment facilities located throughout the United States and have an additional residential facility under development. De novo development plays an important role in the growth of our facility base. Our de novo facility development consists of either building a new facility from the ground up or acquiring an existing facility with an alternative use and repurposing it as a substance abuse treatment facility. In the past two years, we have developed two full-service residential treatment facilities: Greenhouse, a former luxury spa in Dallas, Texas, and Desert Hope, a former assisted living facility in Las Vegas, Nevada. We believe the success of our Greenhouse and Desert Hope facilities provides us with the experience to develop additional premium facilities across the United States with comparable scale, capabilities and quality. Currently, we are developing a new premium facility located in Riverview, Florida that will provide us with an additional 164 beds. We expect this new residential treatment facility to open in the first half of 2015. In addition, we have entered into a purchase agreement to acquire, subject to the satisfaction of certain conditions, a property in Ringwood, New Jersey that we expect to begin developing by early next year into an inpatient facility with approximately 150 beds.

 

    Opportunistically pursue treatment facility acquisitions. We selectively seek opportunities to expand and diversify our geographic presence and service offerings through facility acquisitions. IBISWorld estimates that there were more than 16,700 mental health and substance abuse treatment facilities in operation in 2013, most of which are small, regional operations. We believe this high level of fragmentation presents us with the opportunity to acquire facilities or small providers and upgrade their treatment programs and facilities to improve client care and as a result improve our operating metrics. We believe that our brand recognition, marketing platform and referral network will enable us to improve census at acquired facilities.

 

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    Expand outpatient operations. We actively pursue opportunities to add outpatient centers to complement our broader network of residential treatment facilities. For example, in March 2014 we acquired a property in Arlington, Texas, and in May 2014 we acquired a property in Las Vegas, Nevada. We intend to develop each of these properties in 2014 as outpatient treatment facilities to provide additional programming space for our nearby residential facilities. We believe expanding our reach by acquiring or developing premium outpatient facilities of a quality consistent with our inpatient services will further enhance our brand and our ability to provide a more comprehensive suite of services across the spectrum of care. Outpatient centers are expected to be an increasingly important source of leads for our residential programs as we believe a portion of clients receiving outpatient treatment will ultimately need a higher level of care. Moreover, we believe this will position us to better serve those clients whose payors require outpatient treatment as a prerequisite to any inpatient treatment.

 

    Target complementary growth opportunities. There are additional growth opportunities that we may selectively pursue that are complementary to our current business. These may include, without limitation, providing pharmacy and laboratory services, expanding licensure of existing facilities, treating other mental health and wellness disorders and expanding other ancillary services. We are also aggressively pursuing acquisitions of prospective client databases and other lead sources to improve our referral base.

Our History

In 2004, Jerrod Menz, our President, established a residential drug and alcohol treatment company. In 2008, it was acquired by Forterus, Inc. In 2011, Forterus acquired Performance Revolution (d.b.a. FitRx), which was owned by Michael Cartwright, our Chief Executive Officer. Utilizing Mr. Cartwright’s and Mr. Menz’s skills and prior experiences developing de novo facilities, Forterus began identifying properties to develop into residential treatment centers. In 2011, we purchased Greenhouse, which opened in March 2012, and Desert Hope, which opened in January 2013. In 2012, we consummated the TSN Acquisition, which added three facilities (one of which was subsequently closed) and a national sales and marketing program. In conjunction with the TSN Acquisition, we changed our name to American Addiction Centers, Inc.

Holdings was formed in the first quarter of 2014 and completed the Reorganization Transactions in the second quarter of 2014, which included the Private Share Exchange, the BHR Acquisition and the CRMS Acquisition. As a result of the Reorganization Transactions, Holdings now owns (i) 93.6% of the outstanding common stock of AAC, (ii) 100% of the outstanding common membership interests in BHR, which represents 100% of the voting rights in BHR, and (iii) 100% of the outstanding membership interests in CRMS. See Note 11 to our audited financial statements included elsewhere in this prospectus for a discussion of certain historical corporate actions.

Subsequent to this offering, we expect to conduct a subsidiary short-form merger with AAC whereby the legacy holders who did not participate in the Private Share Exchange would be entitled to receive Holdings shares on a one-for-one basis. We currently expect to register this short-form merger on a Form S-4 registration statement to be filed with the SEC after consummation of this offering. Upon the completion of the short-form merger, Holdings would own 100% of AAC. No assurance can be given that the subsequent short-form merger will occur in a timely manner or at all.

Our Services and Solutions

We provide quality, comprehensive and compassionate care to adults and adolescents struggling with alcohol and/or drug abuse and dependence as well as co-occurring mental health issues. We maintain a research-based, disciplined treatment plan for all clients with schedules designed to engage the client in an enriched recovery experience. Our purpose and passion is to empower the individual, their families and the broader community through the promotion of optimal wellness of the mind, body and spirit.

 

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Our curriculum, which is peer reviewed and research-based, has been recognized as one of our program strengths by the Commission on Accreditation of Rehabilitation Facilities, or CARF, a leader in the promotion and accreditation of quality, value and optimal outcomes of service. In particular, research studies show that certain aspects of our treatment programs, such as offering longer treatment stays, are effective for producing long-term recovery. In addition, we offer a variety of forms of therapy types and settings and related services that the National Institute on Drug Abuse has recognized as effective. We offer the following types of therapy: motivational interviewing, cognitive behavioral therapy, rational emotive behavior therapy, dialectical behavioral therapy, solution-focused therapy, seeking safety, eye movement desensitization and reprocessing, and systematic family intervention. Our variety of therapy settings includes individual, group, family, recovery-oriented challenge, expressive (with a focus on music and art) and equine and trauma therapies.

We offer a full spectrum of treatment services to clients, based upon individual needs as assessed through comprehensive evaluations at admission and throughout participation in the program. The assignment to, and frequency of, services corresponds to individualized treatment plans within the context of the level of care and treatment intensity level.

 

    Detoxification : Detoxification is usually conducted at an inpatient facility for clients with physical or psychological dependence. Detoxification services are designed to clear toxins out of the body so that the body can safely adjust and heal itself after being dependent upon a substance. Clients undergo routine urinalysis screenings and are medically monitored 24 hours per day, seven days per week by experienced medical professionals who work to alleviate withdrawal symptoms through medication, as appropriate. We provide detoxification services for several substances including alcohol, sedatives and opiates.

 

    Residential Treatment : Residential care is a structured treatment approach designed to prepare clients to return to the general community with a sober lifestyle, increased functionality and improved overall wellness. Treatment is provided on a 24 hours per day, seven days per week basis, and services generally include a minimum of two individual therapy sessions per week, regular group therapy, family therapy, didactic and psycho-educational groups, exercise (if cleared by medical staff), case management, routine urinalysis screenings and recreational activities. Medical and psychiatric care is available to all clients, as needed, through our contracted professional physician groups.

 

    Partial Hospitalization : Partial hospitalization is a structured program providing care at least five days a week for no fewer than six hours a day. This program is designed for clients who are stable enough physically and psychologically to participate in everyday activities but who still require a degree of medical monitoring. Services include a minimum of weekly individual therapy, regular group therapy, family education and therapy, didactic and psycho-educational groups, exercise (if cleared by medical staff), case management, routine urinalysis screenings and off-site recovery meetings and activities. Medical and psychiatric care is available to all clients, as needed, through our contracted professional physician groups.

 

    Intensive Outpatient Services : Less intensive than the aforementioned levels of care, intensive outpatient services is a structured program providing care three days a week for three hours per day at a minimum. Designed as a “step down” from partial hospitalization, this program reinforces progress and assists in the attainment of sobriety, reduction of detrimental behaviors and improved overall wellness of clients while they integrate and interact in the community. Services include weekly individual therapy, group therapy, family education and therapy, didactic and psycho-educational groups, case management, frequent urinalysis screenings, off-site recovery meetings and activities and intensive transitional and aftercare planning.

We do not have a fixed number of beds within each of the four levels of care described above. Depending on the specific needs of our client census at any given time, we are able to repurpose beds within a treatment facility to provide varying levels of care, subject to licensure requirements. As a result, rather than tracking the number of beds within a given level of care at any one time, management records and evaluates the number of

 

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billed days for each level of care over a given period of time. For instance, detoxification and residential treatment levels of care feature higher per day gross client charges than partial hospitalization and intensive outpatient levels of care but also require greater levels of more highly trained medical staff. For the six months ended June 30, 2014, detoxification and residential treatment services accounted for 27% of total billed days, and partial hospitalization and intensive outpatient services accounted for the remaining 73% of total billed days. For the fiscal year ended December 31, 2013, detoxification and residential treatment services accounted for 23% of total billed days, and partial hospitalization and intensive outpatient services accounted for the remaining 77% of total billed days.

Considering the high level of co-occurring substance abuse, mental health and medical conditions, we offer clients a spectrum of psychiatric, medical and wellness-focused services based upon his or her individual needs as assessed through comprehensive evaluations at admission and throughout his or her participation in the program. To maximize the likelihood of long-term recovery, all program levels provide clients access to the following services: assessment of individual substance abuse, mental health and medical history and physical within 24 to 72 hours of admission; psychiatric evaluations; psychological evaluations and services based on client needs; follow-up appointments with physicians and psychiatrists; medication monitoring; educational classes regarding health risks, nutrition, smoking cessation, HIV awareness, life skills, healthy nutritional programs and dietary plans; access to fitness facilities; interactive wellness activities such as swimming, basketball and yoga; and structured daily schedules designed for restorative sleep patterns.

In addition, we believe drug testing of clients is an important component of substance abuse treatment. Clients are tested for substances at our facilities (“point-of-care drug testing”) upon admission, on a random basis, and as otherwise determined to be medically necessary. All positive point-of-care drug tests, as well as a portion of the negative point-of-care drug tests, are sent to an off-site laboratory for confirmation or quantitative analysis. In addition, a physician may order any test to be sent to an off-site laboratory for quantitative analysis and confirmation testing if the physician is monitoring medication use or if the client otherwise exhibits indicative behavior. Currently, we process quantitative analysis and confirmation testing for our Nevada and Texas facilities at our gas chromatography-mass spectrometry laboratory located in Brentwood, Tennessee. Quantitative analysis and confirmation testing for our clients in other states is performed by third parties. We intend to obtain licensure to expand our quantitative laboratory testing services to other states where we have facilities. We believe we utilize industry standard practices for drug testing and laboratory services.

We emphasize clinical treatment, as well as the therapeutic value of overall physical and nutritional wellness. We are committed to providing fresh and nutritious meals throughout a client’s stay in order to promote healthy routines beginning with diet and exercise. Some of our facilities offer comprehensive work-out facilities, and many locations offer various exercise classes and other amenities. We support long-term recovery for clients through research-based methodologies and individualized treatment planning while utilizing 12 step programs, which are a set of guiding principles outlining a course of action for recovery.

We believe we have a differentiated ability to manage dual diagnosis cases and coordinate treatment of individuals suffering from the common combination of mental illness and substance abuse simultaneously. These clients participate in education and discussion-oriented groups designed to provide information regarding the psychiatric disorders that co-occur with chemical dependency.

We place a strong emphasis on tracking client satisfaction scores in order to measure our client and staff interaction and overall outcome and reputation. In addition to client satisfaction surveys that we receive after a client’s discharge, we also solicit feedback during a client’s stay at our residential facilities. This allows us to further tailor an individual’s treatment plan to emphasize the programs that have been more impactful and helpful to a particular client.

 

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Properties

We currently operate six substance abuse treatment facilities located throughout the United States staffed by seasoned professionals and experts in the fields of addiction and behavioral health who are committed to providing the care, support, education and hope needed to treat addiction. In addition, we have three substance abuse treatment facilities under development and an additional property under contract. We also operate an obesity treatment center, FitRx. The following table presents information, as of June 30, 2014, about our network of substance abuse treatment facilities, including current facilities, facilities under development and properties under contract:

 

Facility Name (1)    Location   

Capacity

(beds)

  First Clients
Served
 

Treatment

Certifications (2)

   Real Property
Leased /
Owned
Desert Hope    Las Vegas, NV    148   2013   DTX, RTC, PHP, IOP    Owned
Greenhouse   

Grand Prairie, TX

(Dallas area)

   130 (3)   2012   DTX, RTC, PHP, IOP    Owned
Forterus    Temecula, CA    76   2004   DTX, RTC, PHP, IOP    Leased
Singer Island    West Palm Beach, FL    65   2012   PHP, IOP    Leased
San Diego Addiction Treatment Center    San Diego, CA    36   2010   DTX, RTC, PHP, IOP    Leased
The Academy    West Palm Beach, FL    12   2012   PHP, IOP    Leased
TBD   

Riverview, FL

(Tampa area)

   164 (4)   Under

Development (4)

  DTX, RTC, PHP, IOP (4)    Owned
TBD   

Arlington, TX

(Dallas area)

   n/a   Under
Development (5)
  PHP, IOP (5)    Owned
TBD   

Las Vegas, NV

   n/a   Under
Development (6)
  PHP, IOP (6)    Owned
TBD   

Ringwood, NJ

(New York City
area)

   150 (7)   Under
Contract (7)
  DTX, RTC, PHP, IOP (7)    n/a

 

 

(1) Excluded from this table is our non-substance abuse treatment facility, FitRx, which is a 20-bed leased facility located in Brentwood, Tennessee that provides outpatient treatment services for men and women who struggle with obesity-related behavioral disorders.

(2) DTX: Detoxification; RTC: Residential Treatment; PHP: Partial Hospitalization; IOP: Intensive Outpatient.

(3) This figure includes 60 additional beds as a result of the Greenhouse expansion completed in July 2014 with respect to which we received licensure in July 2014.

(4) Reflects our current expectations with respect to this facility, on which we began construction in May 2014 and target opening in the second half of 2015.

(5) In March 2014, we acquired an approximately 20,000 square foot property in Arlington, Texas. We began construction of an outpatient treatment facility at this location in July 2014, and we are targeting opening this facility in the first half of 2015. The facility will provide treatment services and additional programming space for our Greenhouse facility. Treatment certifications reflect our expectations.

(6) In May 2014, we acquired an approximately 20,000 square foot property in Las Vegas, Nevada. We began construction of an outpatient treatment facility at this location in July 2014, and we are targeting opening this facility by the end of 2014. The facility will provide treatment services and additional programming space for our Desert Hope facility. Treatment certifications reflect our expectations.

(7) We entered into a purchase agreement to acquire a 96 acre property located fewer than 50 miles from New York City, subject to the satisfaction of certain closing conditions and the arrangement of financing. We anticipate beginning construction of a residential treatment facility at this location by early 2015, and we are targeting opening this facility in 2016 with approximately 150 beds. Treatment certifications reflect our expectations.

Our leased facilities identified in the table above have entered into third party leases with the following

material terms:

Forterus. The eight properties that comprise the Forterus facility generally have lease terms ranging from one to two years with expiration dates ranging from March 2015 to July 2016. Monthly rent under these

 

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leases ranges from $2,000 to $2,750 plus the cost of utilities. One Forterus facility is a multi-tenant property where we provide clinical services and maintain office space. The lease for this property has a three year term that expired in March 2014, but we continue to occupy the premises and make monthly rent payments of $11,000 plus our proportionate share of certain taxes and the costs of operating and maintaining the premises. We are currently negotiating the extension of certain leases with upcoming termination dates and expect to renew such leases on substantially the same terms, though we cannot provide any assurances that we will be successful in doing so.

Singer Island . The Singer Island facility lease has a term of one year that expires in June 2015. As of July 1, 2014, monthly rent under this lease is $30,000 plus the cost of all utilities.

San Diego Treatment Center . The San Diego Treatment Center lease has a term of five years that expires in March 2015. This lease has an option to extend for an additional five-year term. Monthly rent under this lease is approximately $21,000 plus the cost of all utilities.

The Academy . Two leased properties constitute The Academy facility, one with a month-to-month term and the other with a six month term expiring in December 2014. Total monthly payments under these leases are approximately $8,300 plus utilities, certain taxes and our proportionate share of the costs of operating and maintaining the premises. We also lease properties located in West Palm Beach, Florida through which we provide certain clinical services. Certain leases for these clinical spaces have terms of one to two years, with expiration dates ranging from October 2014 to December 2014, and certain leases are month to month. Aggregate monthly rent under these leases is approximately $21,900. We are currently negotiating the extension of certain leases with upcoming termination dates and expect to renew such leases on substantially the same terms, though we cannot provide any assurances that we will be successful in doing so.

FitRx. The FitRx facility currently leases a property under a lease with a term of 66 months that expires in November 2014. Monthly rent under this lease is approximately $9,400 plus our proportionate share of certain taxes and the costs of operating and maintaining the premises. FitRx recently negotiated a new lease for a different property and plans to allow its existing lease to expire in November 2014. The new FitRx lease has a term of three years that expires in April 2017. This lease has an option to extend for two additional two-year periods. Monthly rent under this lease is approximately $21,000 plus our proportionate share of certain taxes and the costs of operating and maintaining the premises.

In addition, we lease approximately 21,800 square feet of office space in Brentwood, Tennessee for our corporate headquarters under a lease expiring in March 2017. Monthly rent under this lease is approximately $37,500 plus our proportionate share of certain taxes and the costs of operating and maintaining the premises. We also lease approximately 3,350 square feet of laboratory space in Brentwood, Tennessee to perform quantitative drug testing and other laboratory services that support our treatment facilities. Monthly rent under this lease, which expires in May 2018, is approximately $4,300, plus the cost of certain operating expenses and taxes.

Current Facilities

Each of our CARF accredited facilities provides a multidisciplinary approach to facilitate recovery from addiction by providing individuals with temporary homes for a long-term comprehensive program. We maintain premium facilities offering clients aesthetically pleasing properties and grounds, a comfortable environment, high quality and healthy food, numerous amenities and a courteous and attentive staff. We are committed to physical and nutritional wellness, and as part of this effort, we maintain advanced fitness facilities with instructors in several of our facilities and nutritious foods with menus approved by registered dietitians and nutritionists. A brief description of each of our facilities is provided below.

 

    Desert Hope . Located in Las Vegas, Nevada, this facility has a bed capacity of 148, all of which are licensed for detoxification, and provides all levels of care to adults struggling with substance abuse and behavioral health issues. Desert Hope also offers a spirituality program developed by C.C. Nuckols, Eye Movement Desensitization and Reprocessing Therapy, art therapy, personal training, yoga sessions, a 12 step walk and other amenities in a luxurious setting.

 

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    Greenhouse . A former luxury spa in Dallas, Texas, this facility currently has a bed capacity of 70, all of which are licensed for detoxification. In July 2014, we completed the construction of an expansion to this facility, which added 60 beds and increased total bed count to 130 beds. Greenhouse provides all levels of care to adults struggling with substance abuse and behavioral health issues and also offers personal training, yoga sessions, massage therapy and other amenities.

 

    Forterus . Located in Temecula, California, this center has a 76 bed capacity, 24 of which are licensed for detoxification and provides services to adults at all levels of care. Forterus is our original treatment facility and has been operating since 2004. A core component of its clinical model is community integration.

 

    Singer Island . Located in West Palm Beach, Florida, this facility has a 65 bed capacity and provides partial hospitalization and intensive outpatient services to adults struggling with substance abuse and behavioral health issues. Additional services include psychological testing, ongoing college and career services and an extended care program.

 

    San Diego Addiction Treatment Center . Located in San Diego, California, San Diego Addiction Treatment Center has a 36 bed capacity, all of which are licensed for detoxification, for adult males requiring all levels of care. This facility also offers an individualized grief and loss track to clients.

 

    The Academy . Located in West Palm Beach, Florida, this facility has a 12 bed capacity and provides partial hospitalization and intensive outpatient services to adolescents (ages 13–17) struggling with substance abuse and behavioral health issues. Additional services include equine therapy and a specialized curriculum focusing on peer relationships, family and academics.

 

    FitRx . Located in Brentwood, Tennessee, FitRx is a 20-bed program offering partial hospitalization and intensive outpatient services to adults who struggle with behavioral health disorders associated with obesity. FitRx’s programs emphasize behavioral, nutritional and physical wellness.

In addition to substance abuse, we believe several other addiction-related diseases represent large underserved markets. Additionally, the treatment model used at our residential facilities to treat substance abuse can also be applied to treat other compulsive behaviors.

New Property Developments

We have recently acquired three properties in Florida, Nevada and Texas and are in the process of acquiring an additional property that we will begin developing later this year. Each of these future facilities represents an important part of our growth strategy.

 

    Riverview, Florida (Tampa area) . We acquired a former boarding school for youths and intend to develop the property into a facility that will provide all levels of care to clients struggling with substance abuse and behavioral health issues. We began construction of a residential treatment facility at this location in May 2014, and we are targeting opening this facility in the second half of 2015 with 164 licensed beds.

 

    Arlington, Texas (Dallas area) . In March 2014, we acquired an approximately 20,000 square foot property in Arlington, Texas. We began construction of an outpatient treatment facility at this location in July 2014, and we are targeting opening this facility in the first half of 2015. The facility will provide treatment services and additional programming space for our Greenhouse facility.

 

    Las Vegas, Nevada . We acquired an approximately 20,000 square foot property in Las Vegas, Nevada in May 2014. We began construction of an outpatient treatment facility at this location in July 2014, and we are targeting opening this facility by the end of 2014. The facility will provide treatment services and additional programming space for our Desert Hope facility.

 

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    Ringwood, New Jersey (New York City area). We have entered into a purchase agreement to acquire, subject to certain closing conditions and the arrangement of financing, a former convent on 96 acres located fewer than 50 miles from New York City, with convenient access to LaGuardia and Newark airports. We anticipate beginning construction by early 2015, and we are targeting opening this residential treatment facility in 2016 with 150 licensed beds.

Sales and Marketing

Sales and marketing supports the development of our brand and advances our comprehensive lead-generation platform. Total sales and marketing spend was $24.3 million in 2013 driven by our program’s multi-faceted sales and marketing engine. The primary sources of our new clients include:

 

    National Sales Force. We deploy and manage a sales force of 35 representatives nationwide that became part of our organization as a result of the TSN Acquisition in August 2012 and focuses primarily on marketing to hospitals, other treatment facilities, employers, alumni and employee assistance programs. In addition, our varied facilities located across the United States allow us to reach a broad audience of potential clients and their families and build a nationally recognized brand. This nationally branded, multi-channel approach has led to an increase in our number of admitted clients from 2,934 in 2012 to 4,027 in 2013, a 37.3% growth rate.

 

    Recommendations by Alumni. We often receive new clients who were directly referred to our facilities by our alumni as well as their friends and families. As our national brand continues to grow and our business continues to increase, we believe our alumni will become an increasingly important source of business for us.

 

    Internet/TV/Print Advertising. Advertising through various media represents another important opportunity to obtain new clients as well as to develop our national brand. In September 2012, Mr. Cartwright released a motivational book titled Believable Hope: Five Essential Elements to Beat Any Addiction that chronicles his own personal journey overcoming addiction. Believable Hope represents a valuable marketing tool and serves as a key mechanism for treatment reinforcement. We maintain and run a series of television commercials that promote our facilities and overall capabilities. We also maintain a strong presence on the internet. We have made further advertising efforts in radio spots, newspaper articles, medical journals and other print media with the intent to build our integrated, national brand.

 

    Paid Calls and Clicks. We also pay to have potential clients directed to us via telephone or online in order to increase the size of our client and prospect database. Additionally, we are actively focused on obtaining website domain names to bring in additional admissions based on user search histories.

Call Center Operations

We maintain a 24 hours per day, seven days per week call center currently staffed by over 60 employees. Our centralized call center is situated at our corporate headquarters in Brentwood, Tennessee, and focuses on enrolling clients identified by our sales and marketing activities into new client admissions. As part of its role, the call center team conducts benefits verification and handles all communication with insurance companies, completes client assessments, begins the pre-certification process for treatment authorization, chooses the proper treatment facility for the client’s clinical and financial needs and assists clients with arrangements and logistics.

Professional Groups

We are affiliated with a Professional Group in each of the five states in which we operate. These Professional Groups engage physicians and mid-level service providers and provide professional services to our clients through professional services agreements with each treatment facility. Under the professional services agreements, the Professional Groups also provide a physician to serve as medical director for the applicable

 

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facility. The Professional Groups either bill the payor for their services directly or are compensated by the treatment facility based on fair market value hourly rates. Each of the professional services agreements has a term of five years and will automatically renew for additional one year periods. For additional information related to the Professional Groups, see Note 5 to our audited financial statements included elsewhere in this prospectus.

We provided the initial working capital funding in connection with the formation of the Professional Groups in return for a receivable. We make additional advances to the Professional Groups during periods in which there is a shortfall between revenues collected by the Professional Group from the treatment facilities and payors, on the one hand, and the Professional Group’s contracting expenses and payroll requirements, on the other hand, thereby increasing the balance of the receivable. Excess cash flow of the Professional Groups is repaid to us, resulting in a decrease in the receivable. The Professional Groups are obligated to repay these funds and are charged commercially reasonable interest. Any receivables due to us from the Professional Groups are eliminated in the consolidation of the Professional Groups as VIEs.

AAC has entered into written management services agreements with each of the Professional Groups, under which AAC provides management and other administrative services to the Professional Groups. These services include billing, collection of accounts receivable, accounting, management and human resource functions and setting policies and procedures. Pursuant to the management services agreements, the Professional Groups’ monthly revenues will first be applied to the payment of operating expenses consisting of refunds or rebates owed to clients or payors, compensation expenses of the physicians and other service providers, lease payments, professional and liability insurance premiums and any other costs or expenses incurred by AAC for the benefit of the Professional Groups and, thereafter, to the payment to AAC of a management fee equal to 20% of the Professional Groups’ gross collected monthly revenues. As described above, AAC will also provide financial support to each Professional Group on an as-needed basis to cover any shortfall between revenues collected by the Professional Group from the treatment facilities and payors and the Professional Group’s contracting expenses and payroll requirements. Through these arrangements, we are directing the activities that most significantly impact the financial results of the respective Professional Groups; however, treatment decisions are made solely by licensed healthcare professionals employed or engaged by the Professional Groups as required by various state laws. Based on our ability to direct the activities that most significantly impact the financial results of the Professional Groups, provide necessary funding and the obligation and likelihood of absorbing all expected gains and losses, we have determined that we are the primary beneficiary, and, therefore, consolidate the five Professional Groups as variable interest entities.

Competition

We believe we are one of the largest for-profit companies focused on substance abuse treatment in the United States. According to IBISWorld, approximately 77% of all substance abuse treatment clinics in the United States have a single location, and approximately 44% of all substance abuse treatment facilities have fewer than 20 employees. Many of the largest for-profit addiction treatment providers operate in the broader behavioral healthcare sector without focusing primarily on substance abuse. We believe our size and core focus on substance abuse treatment provide us with an advantage over competitors in terms of building our brand and marketing our platform to potential clients.

The market for mental health and substance abuse treatment facilities is highly fragmented with approximately 16,700 different facilities providing services to the adult and adolescent population, of which only 33% are operated by for-profit organizations. Our residential treatment facilities compete with several national competitors and many regional and local competitors. Some of our competitors are government entities and supported by tax revenues, and others are non-profit entities that are primarily supported by endowments and charitable contributions. We do not receive financial support from these sources. Some larger companies in our industry, including Acadia Healthcare Company, Inc. and CRC Health Corp., compete with us on a national scale and offer substance abuse treatment services among other behavioral healthcare services. To a lesser extent, we also compete with other providers of substance abuse treatment services, including other inpatient behavioral healthcare facilities and general acute care hospitals.

 

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We believe the primary competitive factors affecting our business include:

 

    quality of clinical programs and services;

 

    reputation and brand recognition;

 

    overall aesthetics of the facilities;

 

    amenities offered to clients; and

 

    relationships with payors and referral sources.

Sources of Revenue

Our revenues primarily consist of service charges related to providing addiction and behavioral health treatment and other ancillary services associated with serving our clients, such as the collection and laboratory testing of urine for controlled substances. For the year ended December 31, 2013 and for the six months ended June 30, 2014, approximately 90% of our revenues were reimbursable by commercial payors, including amounts paid by such payors to clients, with the remaining portion payable directly by our clients. For the year ended December 31, 2013, approximately 12.3% of our revenue reimbursements came from Blue Cross Blue Shield of California, 12.1% came from Aetna and 10.3% came from United Behavioral Health. No other payor accounted for more than 10% of our revenue reimbursements for the year ended December 31, 2013. For the six months ended June 30, 2014, approximately 14.5% of our revenue reimbursements came from Anthem Blue Cross Blue Shield of Colorado, 12.5% came from Blue Cross Blue Shield of California, 12.3% came from Aetna and 10.4% came from Blue Cross Blue Shield of Texas. No other payor accounted for more than 10% of our revenue reimbursements for the six months ended June 30, 2014.

Regulatory Matters

Overview

Substance abuse treatment providers are regulated extensively at the federal, state and local levels. In order to operate our business and obtain reimbursement from third-party payors, we must obtain and maintain a variety of licenses, permits, certifications and accreditations. We must also comply with numerous other laws and regulations applicable to the conduct of business by substance abuse treatment providers. Our facilities are also subject to periodic on-site inspections by the agencies that regulate and accredit them in order to determine our compliance with applicable requirements.

The laws and regulations that affect substance abuse treatment providers are complex, change frequently and require that we regularly review our organization and operations and make changes as necessary to comply with changes in the law or new interpretations of laws or regulations. Significant public attention has focused in recent years on the healthcare industry, directing attention not only to the conduct of industry participants but also to the cost of healthcare services. In recent years, there have been heightened coordinated civil and criminal enforcement efforts relating to the healthcare industry by both federal and state government agencies. The ongoing investigations relate to, among other things, various referral practices, cost reporting, billing practices, credit balances, physician ownership and joint ventures involving hospitals and other healthcare providers. We expect that healthcare costs and other factors will continue to encourage both the development of new laws and regulations and increased enforcement activity.

We believe we are in substantial compliance with all applicable laws and regulations and are not aware of any material pending or threatened investigations involving allegations of wrongdoing. While no such regulatory inquiries have been made, compliance with such laws and regulations can be subject to future government review and interpretation, as well as significant regulatory action including fines, penalties and exclusion from government health programs.

 

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Licensure, Accreditation and Certification

All of our substance abuse treatment facilities are licensed under applicable state laws where licensure is required. Licensing requirements typically vary significantly depending upon the state in which a facility is located and the types of services provided. The types of licensed services that our facilities provide include intensive outpatient, community housing, adult residential, outpatient treatment, partial hospitalization and medical detoxification. In addition, our employed case managers, therapists and medical technicians may be subject to individual state license requirements.

Our Desert Hope facility is, and any future facilities that store and dispense controlled substances will be, required to register with the U.S. Drug Enforcement Administration, or DEA, and abide by DEA regulations regarding controlled substances. Finally, each of our treatment facilities has a certificate under the Clinical Laboratory Improvement Amendments of 1988, or CLIA, to conduct urinalysis screening for its clients.

Each of our substance abuse treatment facilities has obtained accreditation from the Commission on Accreditation of Rehabilitation Facilities, or CARF, which is the primary accreditation body in the substance abuse treatment industry. CARF accredits behavioral health organizations providing mental health and alcohol and drug use and addiction treatment services, as well as opiate treatment programs, and many other types of programs. This type of accreditation program is intended to improve the quality, safety, outcomes and value of healthcare services provided by accredited facilities. CARF requires an initial application and completion of on-site surveys demonstrating compliance with accreditation requirements. Accreditation is granted for a specified period, typically ranging from one to three years, and renewals of accreditation require completion of a renewal application and an on-site renewal survey.

We believe that all of our facilities and programs are in substantial compliance with current applicable state and local licensure, certification and accreditation requirements. In addition, we believe all of our facilities are in substantial compliance with the standards of CARF. Periodically, state and local regulatory agencies as well as accreditation entities conduct surveys of our facilities and may find from time to time that a facility is not in full compliance with all of the accreditation standards. Upon receipt of any such finding, the facility timely submits a plan of correction and corrects any cited deficiencies.

Fraud, Abuse and Self-Referral Laws

We do not currently bill or accept payments from any federal healthcare programs. Therefore, we are generally not impacted by the anti-kickback provisions of the Social Security Act, and our operations are not subject to the federal prohibition on physician self-referrals, commonly referred to as the Stark Law. However, many states have passed anti-kickback statutes and physician self-referral prohibitions similar to the federal statutes and regulations. These state laws are often drafted broadly to cover all payors (i.e., not restricted to Medicare and other federal healthcare programs) and often lack interpretative guidance. A violation of these laws could result in a prohibition on billing payors for such services, result in civil or criminal penalties and could adversely affect the state license of any program or facility found to be in violation.

Federal prosecutors have broad authority to prosecute healthcare fraud even when federal healthcare programs are not involved. For example, federal law criminalizes the knowing and willful execution or attempted execution of a scheme or artifice to defraud any healthcare benefit program as well as obtaining by false pretenses any money or property owned by any healthcare benefit program. Federal law also prohibits embezzlement of healthcare funds, false statements relating to healthcare and obstruction of the investigation of criminal offenses. All of these federal criminal offenses are enforceable regardless of whether an entity or individual participates in the Medicare program or any other federal healthcare program.

 

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False Claims

We are subject to state and federal laws that govern the submission of claims for reimbursement. These laws generally prohibit an individual or entity from knowingly and willfully presenting a claim (or causing a claim to be presented) for payment from Medicare, Medicaid or other third-party payors that is false or fraudulent. The standard for “knowing and willful” often includes conduct that amounts to a reckless disregard for whether accurate information is presented by claims processors. Penalties under these statutes include substantial civil and criminal fines, exclusion from the Medicare program and imprisonment.

One of the most prominent of these laws is the federal False Claims Act, or FCA, which may be enforced by the federal government directly or by a qui tam plaintiff (or whistleblower) on the government’s behalf. When a private plaintiff brings a qui tam action under the FCA, the defendant often will not be made aware of the lawsuit until the government commences its own investigation or determines whether it will intervene. When a defendant is determined by a court of law to be liable under the FCA, the defendant may be required to pay three times the amount of the alleged false claim, plus mandatory civil penalties of between $5,500 and $11,000 for each separate false claim. As we do not submit claims to any federal healthcare program, the FCA poses minimal risk to our facilities.

Many states have passed false claims acts similar to the FCA. Under these laws, the government may impose a penalty and recover damages, often treble damages, for knowingly submitting or participating in the submission of claims for payment that are false or fraudulent or which contain false or misleading information. These laws may be limited to specific programs (such as state workers’ compensation programs) or may apply to all payors. In many cases, alleged violations of these laws may be brought by a whistleblower who may be an employee, a referring physician, a competitor, a client or other individual or entity, and who may be eligible for a portion of any recovery. Further, like the federal law, state false claims act laws generally protect employed whistleblowers from retribution by their employers.

Although we believe that we have procedures in place to ensure the accurate completion of claims forms and requests for payment, the laws, regulations and standards defining proper billing, coding and claim submission are complex and have not been subjected to extensive judicial or agency interpretation. Billing errors can occur despite our best efforts to prevent or correct them, and we cannot assure you that the government or a payor will regard such errors as inadvertent and not in violation of the applicable false claims act laws or related statutes.

Privacy and Security Requirements

There are numerous federal and state regulations that address the privacy and security of client health information. In particular, federal regulations issued under the Drug Abuse Prevention, Treatment and Rehabilitation Act of 1979 strictly restrict the disclosure of client identifiable information related to substance abuse and apply to any of our facilities that receive any federal assistance, which is interpreted broadly to include facilities licensed, certified or registered by a federal agency. Further, the HIPAA privacy and security regulations extensively regulate the use and disclosure of individually identifiable health information (known as “protected health information”) and require covered entities, which include most health providers, to implement and maintain administrative, physical and technical safeguards to protect the security of such information. Additional security requirements apply to electronic protected health information. These regulations also provide clients with substantive rights with respect to their health information.

The HIPAA privacy and security regulations also require our substance abuse treatment programs and facilities to impose compliance obligations by written agreement on certain contractors to whom our programs disclose client information known as “business associates.” The requirements for agreements with business associates changed in 2013, requiring us and other entities subject to HIPAA to revise existing agreements or to enter into new agreements. Compliance with these revised standards was required beginning September 23, 2013, except that existing business associate agreements may qualify for an extended compliance date of September 23,

 

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2014. Covered entities may be subject to penalties as a result of a business associate violating HIPAA if the business associate is found to be an agent of the covered entity. Business associates are now also directly subject to liability under the HIPAA privacy and security regulations. In instances where our programs act as a business associate to a covered entity, there is the potential for additional liability beyond the program’s covered entity status.

Covered entities must report breaches of unsecured protected health information to affected individuals without unreasonable delay but not to exceed 60 days of discovery of the breach by a covered entity or its agents. Notification must also be made to HHS and, in certain situations involving large breaches, to the media. HHS is required to publish on its website a list of all covered entities that report a breach involving more than 500 individuals. In a 2013 final rule, HHS modified this breach notification requirement by creating a presumption that all non-permitted uses or disclosures of unsecured protected health information are breaches unless the covered entity or business associate establishes that there is a low probability the information has been compromised. Various state laws and regulations may also require us to notify affected individuals in the event of a data breach involving individually identifiable information without regard to whether there is a low probability of the information being compromised.

Violations of the HIPAA privacy and security regulations may result in civil penalties of up to $50,000 per violation for a maximum civil penalty of $1,500,000 in a calendar year for violations of the same requirement. HIPAA also provides for criminal penalties of up to $250,000 and ten years in prison, with the severest penalties for obtaining or disclosing protected health information with the intent to sell, transfer or use such information for commercial advantage, personal gain or malicious harm. In addition, state attorneys general may bring civil actions seeking either injunction or damages in response to violations of the HIPAA privacy and security regulations that threaten the privacy of state residents. HHS is required to impose penalties for violations resulting from willful neglect and is required to perform compliance audits.

Our programs remain subject to any privacy-related federal or state laws that are more restrictive than the HIPAA privacy and security regulations. These laws vary by state and could impose additional requirements and penalties. For example, some states impose strict restrictions on the use and disclosure of health information pertaining to mental health or substance abuse treatment. The Federal Trade Commission also uses its consumer protection authority to initiate enforcement actions in response to data breaches.

We enforce a health information privacy and security compliance plan, which we believe complies with the HIPAA privacy and security regulations and other applicable requirements. Compliance with federal and state privacy and security requirements has required and will continue to require us to expend significant resources.

Mental Health Parity Legislation and the Affordable Care Act

The regulatory framework in which we operate is constantly changing. Both the Mental Health Parity legislation and the Affordable Care Act may require that we make operational changes to comply with such laws and regulations. The Mental Health Parity and Addiction Equity Act of 2008, or MHPAEA, is a federal parity legislation that requires large group health insurance plans that offer mental health and addiction coverage to provide that coverage on par with financial and treatment coverage offered for other illnesses. Health plans that do not already cover mental health treatments will not be required to do so, and health plans are not required to provide coverage for every mental health condition published in the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association. The MHPAEA also contains a cost exemption that operates to exempt a group health plan from the MHPAEA’s requirements if compliance with the MHPAEA becomes too costly. HHS issued interim rules implementing MHPAEA in February 2010 and final rules in November 2013.

The Affordable Care Act poses both opportunities and risks for us. The Affordable Care Act represents significant change to the healthcare industry, including reforming the health insurance market, adopting a number

 

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of payment reform measures, attempting to reduce the overall growth rate of healthcare spending, strengthening fraud and abuse enforcement as well as adopting numerous specific provisions applicable to individual segments of the healthcare industry. The impact of the Affordable Care Act on each of our programs may vary. Further, its overall impact is difficult to determine because of uncertainty around a number of factors, including issues around the timing and manner of implementation, the possibility of amendment, repeal or judicial modification, and our inability to predict how individuals, employers, health plans and providers will react to the requirements of the Affordable Care Act.

We believe that one permanent effect of the Affordable Care Act has been an increase in payment reform efforts by federal and state government payors and commercial payors. These efforts take many forms including the growth of ACOs, pay-for-performance bonus arrangements, partial capitation arrangements and the bundling of services into a single payment. The result of these efforts is that more risk of the overall cost of care is being transferred to providers. As institutional providers and their affiliated physicians assume more risk for the cost of care, we expect more services to be furnished within provider networks formed to accept these types of payment reforms. Our ability to compete and retain our traditional sources of clients may be adversely affected by our exclusion from such networks or our inability to be included in such networks.

Overall, the expansion of health insurance coverage under the Affordable Care Act is expected to be beneficial to the substance abuse treatment industry. Beginning January 1, 2014, health insurers are prohibited from denying coverage to individuals because of preexisting conditions. Further, all new small group and individual market health plans are required to cover ten essential health benefit categories, which include mental health and substance abuse disorder services. Likewise, beginning January 1, 2014, the small group and individual market plans are required to comply with the requirements of MHPAEA. According to HHS estimates published in February 2013, these changes are expected to expand coverage for mental health and substance abuse disorders for another 62.5 million Americans.

It is estimated that only 10.8% of those suffering with substance abuse disorders actually seek treatment. Accordingly, the expansion of commercial insurance for substance abuse treatment services may result in a higher demand for services from all providers. It is also likely to bring new competitors to the market, some of which may be better capitalized and have greater market penetration than we do. Further, we expect increased demand for substance abuse treatment services to also increase the demand for case managers, therapists, medical technicians and others with clinical expertise in substance abuse treatment that may make it both more difficult to adequately staff our substance abuse treatment facilities and could significantly increase our costs in delivering treatment, which may adversely affect both our operations and profitability. This increased demand may be tempered somewhat by another provision of the Affordable Care Act that budgets $25 million in grants and assistance to increase the number of mental health and behavioral health professionals.

CLIA and State Lab Licensure

In addition to the testing performed at our laboratory facility, each of our treatment facilities conducts low complexity urinalysis testing and possesses a federal certification under CLIA and, where necessary, applicable state and local licenses. Under CLIA, we are required to hold a certificate applicable to the type of clinical laboratory tests that we perform, which require compliance with certain CLIA-imposed standards based upon the relative complexity of the level of testing that we are actually performing. CLIA regulates clinical laboratory testing by requiring that laboratories be certified by the federal government and comply with various operational, personnel, facilities administration, quality and proficiency requirements intended to ensure that laboratory testing services are accurate, reliable and timely. CLIA does not preempt state laws that are more stringent than federal law.

Pursuant to CLIA, a review is required to renew the certificates every two years. Additionally, we are regularly subject to survey and inspection to assess compliance with program standards and may be subject to additional random inspections. Standards for testing under CLIA are based on the level of complexity of the tests

 

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performed by the laboratory. Laboratories performing high complexity testing are required to meet more stringent requirements than laboratories performing less complex tests. Our facilities currently are certified for waiver testing because they only furnish urinalysis, a low complexity test. Our laboratory currently is certified for complex testing.

In addition to CLIA requirements, we are subject to various state laws. CLIA provides that a state may adopt laboratory regulations that are more stringent than those under federal law, and a number of states, including California and other states in which we operate, have implemented their own laboratory regulatory requirements. State laws may require that laboratory personnel meet certain qualifications, specify certain quality controls or prescribe record maintenance requirements.

Additionally, many state licensure laws require a laboratory that solicits or tests specimens from individuals within that state to hold a license from that state, even if the testing occurs in another state. In particular, California, Florida and New Jersey require out-of-state laboratories to hold state licenses.

Health Planning and Certificates of Need

The construction of new healthcare facilities, the expansion of existing facilities, the transfer or change of ownership of existing facilities and the addition of new beds, services or equipment may be subject to state laws that require prior approval by state regulatory agencies under certificate of need laws. These laws generally require that a state agency determine the public need for construction or acquisition of facilities or the addition of new services. Review of certificates of need and other healthcare planning initiatives may be lengthy and may require public hearings. Violations of these state laws may result in the imposition of civil sanctions or revocation of a facility’s license. Currently, no states in which we operate have certificate of need requirements for substance abuse treatment centers applicable to our facilities.

Other State Healthcare Laws

Most states have a variety of laws that may potentially impact our operations and business practices. For instance, many states in which our programs operate prohibit corporations (and other legal entities) from practicing medicine by employing physicians and certain non-physician practitioners. These prohibitions on the corporate practice of medicine impact how our programs structure their relationships with physicians and other affected non-physician practitioners. These arrangements, however, have typically not been vetted by either a court or the affected regulatory body.

Similarly, many states prohibit physicians from sharing a portion of their professional fees with any other person or entity. These so-called fee-splitting prohibitions range from prohibiting arrangements resembling a kickback to broadly prohibiting percentage-based compensation and other variable compensation arrangements with physicians.

If our arrangements with physicians were found to violate a corporate practice of medicine prohibition or a state fee-splitting prohibition, our contractual arrangements with physicians in such states could be adversely affected, which, in turn, may adversely affect both our operations and revenues. Further, we could face sanctions for aiding and abetting the violation of the state’s medical practice act.

Local Land Use and Zoning

Municipal and other local governments also may regulate our treatment programs. Many of our facilities must comply with zoning and land use requirements in order to operate and many of our de novo acquisition targets will be contingent upon zoning and land use approvals. For example, local zoning authorities regulate not only the physical properties of a healthcare facility, such as its height and size, but also the location and activities of the facility. In addition, community or political objections to the placement of treatment facilities can result in delays in the land use permit process and may prevent the operation of facilities in certain areas.

 

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Risk Management and Insurance

The healthcare industry in general continues to experience an increase in the frequency and severity of litigation and claims. As is typical in the healthcare industry, we could be subject to claims that our services have resulted in injury to our clients or had other adverse effects. In addition, resident, visitor and employee injuries could also subject us to the risk of litigation. While we believe that quality care is provided to our clients and that we materially comply with all applicable regulatory requirements, an adverse determination in a legal proceeding or government investigation could have a material adverse effect on our financial condition.

We maintain commercial insurance coverage on an occurrence basis for general and professional liability claims with no deductible, a primary $1 million per claim limit and an annual aggregate primary limit of $3 million with umbrella coverage for an additional $20 million limit.

Compliance Programs

Compliance with government rules and regulations is a significant concern throughout our industry, in part due to evolving interpretations of these rules and regulations. We seek to conduct our business in compliance with all statutes and regulations applicable to our operations. To this end, we have established an informal compliance program that reviews for regulatory compliance procedures, policies and facilities throughout our business. Our executive management team is responsible for the oversight and operation of our compliance program. We provide periodic and comprehensive training programs to our personnel, which are intended to promote the strict observance of our policies designed to ensure compliance with the statutes and regulations applicable to us. To better focus our compliance efforts, we intend to develop a formal compliance program in 2014.

Environmental Matters

We are subject to various federal, state and local environmental laws that: (i) regulate certain activities and operations that may have environmental or health and safety effects, such as the handling, storage, transportation, treatment and disposal of medical waste products generated at our facilities, the presence of other hazardous substances in the indoor environment and protection of the environment and natural resources in connection with the development or construction of our facilities; (ii) impose liability for costs of cleaning up, and damages to natural resources from, past spills, waste disposals on and off-site or other releases of hazardous materials or regulated substances; and (iii) regulate workplace safety. Some of our facilities generate infectious or other hazardous medical waste due to the illness or physical condition of our clients. The management of infectious medical waste is subject to regulation under various federal, state and local environmental laws, which establish management requirements for such waste. These requirements include record-keeping, notice and reporting obligations. Management believes that our operations are generally in compliance with environmental and health and safety regulatory requirements or that any non-compliance will not result in a material liability or cost to achieve compliance. Historically, the costs of achieving and maintaining compliance with environmental laws and regulations at our facilities have not been material. However, we cannot assure you that future costs and expenses required for us to comply with any new, or changes in existing, environmental and health and safety laws and regulations or new or discovered environmental conditions will not have a material adverse effect on our business, financial condition or results of operations.

Employees

As of June 30, 2014, we employed 715 people, consisting of 634 full-time employees and 81 part-time employees. None of our employees is represented by a labor union or covered by a collective bargaining agreement. We believe that our employee relations are good.

 

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Legal Proceedings

From time to time, we may be engaged in various lawsuits and legal proceedings in the ordinary course of our business. Except as described below, we are currently not aware of any legal proceedings the ultimate outcome of which, in our judgment based on information currently available, would have a material adverse effect on our business, financial condition or results of operations.

Bevell Litigation

On February 3, 2014, AAC filed an action against James D. Bevell in the U.S. District Court in the Middle District of Tennessee, alleging breach of contract and tortious interference with business practices arising out of Mr. Bevell’s breach of his non-compete agreements. Mr. Bevell is the former Chief Innovation Officer of AAC and owns 4.5% of the outstanding common stock of AAC as of June 30, 2014. AAC’s complaint seeks preliminary and permanent injunctive relief, declaratory judgment, compensatory damages, punitive damages for intentional, fraudulent, reckless or grossly negligent conduct, reasonable attorneys’ fees and costs and other legal, equitable or general relief for breach of contract and associated wrongs. On March 5, 2014, the court granted a preliminary injunction enjoining Mr. Bevell and his officers, agents, servants, employees, attorneys and all persons in active concert or participation with him from violating the non-competition and non-solicitation provisions contained in his employment agreement with AAC and in the purchase agreement related to the TSN Acquisition. The parties have engaged in preliminary discussions regarding possible settlement of these matters; however, there is no assurance that these discussions will be successful.

On July 16, 2014, Mr. Bevell filed an action, for which an amended complaint was filed on August 15, 2014, in the Chancery Court for the State of Tennessee in Williamson County against Michael Cartwright, Jerrod Menz, AAC Holdings, Inc., Clinical Revenue Management Services, LLC, Tina Cartwright, Victoria Menz, Behavioral Healthcare Realty, LLC and AAC. The amended complaint alleges the defendants breached fiduciary duties owed to Mr. Bevell and breached the Agreement Among Stockholders entered into in connection with the TSN Acquisition. Mr. Bevell’s amended complaint seeks rescission of the Reorganization Transactions and compensatory and punitive damages. We intend to vigorously defend these claims and believe them to be without merit. The parties have engaged in preliminary discussions regarding possible settlement of these matters; however, there is no assurance that these discussions will be successful.

Horizon Blue Cross Blue Shield of New Jersey v. Avee Laboratories et al.

On September 4, 2013, Horizon Blue Cross Blue Shield of New Jersey (“Horizon”) filed an amended complaint in the Superior Court of New Jersey against several defendants, including Leading Edge Recovery Center, LLC, one of our subsidiaries. Leading Edge Recovery Center, LLC formerly operated a drug and alcohol treatment facility in New Jersey. Horizon alleges the defendants submitted and caused others to submit unnecessary drug tests in violation of New Jersey law and is seeking recovery for monetary and treble damages. We are vigorously defending these claims and believe them to be without merit. We cannot provide any assurance that we will prevail in this matter, nor can we reasonably estimate our potential liability if there is an adverse outcome. Further, we have made a demand for indemnification upon James D. Bevell for the portion of these claims relating to the period prior to the TSN Acquisition. We cannot provide any assurance that we will prevail in our indemnity claim with Mr. Bevell for any portion of these claims.

 

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MANAGEMENT

Our Board of Directors consists of seven members, including a majority of directors who are independent within the meaning of the listing standards of the NYSE. Each of our directors will be elected by our stockholders at our annual meeting of stockholders to serve until the next annual meeting of our stockholders and until his successor is duly elected and qualified. The first annual meeting of our stockholders after this offering will be held in 2015.

Executive Officers and Directors

The following persons are our directors and executive officers as of the date of this prospectus:

 

Name

  

Age

  

Position

Michael T. Cartwright

   46    Chief Executive Officer and Chairman of the Board

Jerrod N. Menz

   41    President and Director

Kirk R. Manz

   47    Chief Financial Officer

Candance A. Henderson-Grice

   47    Chief Operating Officer

Kathryn Sevier Phillips

   43    General Counsel and Secretary

Andrew W. McWilliams

   42    Chief Accounting Officer

Darrell S. Freeman, Sr.

   49    Lead Independent Director

Jerry D. Bostelman

  

45

   Director

Lucius E. Burch, III

  

72

   Director

David C. Kloeppel

   45    Director

Richard E. Ragsdale

   70    Director

Michael T. Cartwright, Chairman and Chief Executive Officer . Mr. Cartwright has served as Chairman of our Board of Directors since 2011 and currently serves as our Chief Executive Officer, a position he has held since June 2013. Mr. Cartwright has almost 20 years of experience in the addiction treatment industry. In 2009, Mr. Cartwright co-founded Performance Revolution, LLC (d/b/a FitRx), a company focused on weight management, and served as its chief executive officer until it merged into Forterus, Inc. in 2011. In 1999, he founded Foundations Recovery Network, LLC, a national alcohol and drug treatment company, and served on its Board of Directors and as its president and chief executive officer until 2009. Additionally, in 1995, Mr. Cartwright founded Foundations Associates, a not-for-profit alcohol and drug treatment center in Nashville, Tennessee, and served on its Board of Directors and as its chief executive officer until its purchase by Foundations Recovery Network, LLC in 2007. While at Foundations Associates, Mr. Cartwright conducted over 10 federally funded research studies on dual diagnosis and addiction. Mr. Cartwright also served on the U.S. Senate Help Subcommittee on Substance Abuse and Mental Health Services from 2003 to 2004. Based on his knowledge of our company, its business and his extensive experience in the addiction treatment industry, we have determined that Mr. Cartwright should serve as Chairman of our Board of Directors. Mr. Cartwright is a graduate of Trevecca Nazarene University.

Jerrod N. Menz, President . Mr. Menz currently serves as our President, a position he has held since June 2013, and has almost 18 years of experience in the drug and alcohol treatment industry. He previously served as the chief executive officer of American Addiction Centers, Inc. (formerly Forterus, Inc.) from 2011 until 2013. From 2009 until 2011, he served Forterus, Inc. in the roles of Vice President and Secretary. In 2004, Mr. Menz founded ABTTC, Inc. (d/b/a A Better Tomorrow), an alcohol and drug treatment provider in southern California, until Forterus, Inc. acquired A Better Tomorrow in 2008. Prior to founding A Better Tomorrow, Mr. Menz served as general manager of Wits Inn, a drug and alcohol treatment facility in Southern California, from 1997 through 2003 and as Vice President of Marketing of Chapman House Addiction Facilities, a drug and alcohol treatment facility in Orange, California, from 2003 to 2004. Based on his knowledge of our company, its business and his extensive experience in the addiction treatment industry, we have determined that Mr. Menz should serve as a director. Mr. Menz is a graduate of the University of Pittsburgh.

Kirk R. Manz, Chief Financial Officer . Mr. Manz joined the company as Chief Financial Officer in January 2011. From 2008 through 2010, Mr. Manz served as chief executive officer of GMD Holdings, Inc. (d/b/a Blast Panel),

 

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a digital media company. From 2006 through 2008, Mr. Manz served as managing member of Private Capital Securities, LLC, a boutique investment banking firm. From 2004 through 2006, Mr. Manz served as vice president of investments for Piper Jaffray & Co. From 2002 through 2004, Mr. Manz worked as a fixed income specialist for Stephens Inc. From 1988 through 2002, Mr. Manz was co-founder or chief executive officer of four communications companies including Igaea, Inc., an international VoIP telecommunications provider. Mr. Manz is a graduate of Vanderbilt University.

Candance A. Henderson-Grice, Chief Operating Officer. Ms. Henderson-Grice joined the company in February 2013 as our Chief Operating Officer and has over 22 years’ experience in the behavioral health industry. From 2001 through 2012, she worked at CRC Health Corporation in various capacities, including president of CRC’s healthy living division which included four eating disorder sites, a residential weight management program, two weight management schools and 12 summer camps; vice president of operations for CRC’s eating disorders, weight management and Florida programs; vice president of operations of CRC’s high-end private pay and Florida facilities which included CRC’s flagship program, Sierra Tucson; and as vice president of CRC’s Southern Region. From 1992 to 2001, she worked for Comprehensive Addiction Programs, which was purchased by CRC in 2003, where she held roles including special projects director, director of operations and chief executive officer of various Comprehensive Addiction Programs facilities. Ms. Henderson-Grice is a graduate of the University of Alabama at Birmingham and Troy State University.

Kathryn Sevier Phillips, General Counsel and Secretary.  Ms. Phillips joined the company in December 2013 as General Counsel and Secretary. From 2009 to 2013, Ms. Phillips served as Managing Partner of Sevier Phillips & Associates, a legal, compliance and political consulting practice focused primarily on healthcare clients. From 2004 to 2008, Ms. Phillips was general counsel and secretary of National Renal Alliance, LLC, a national renal disease management and dialysis provider, where Ms. Phillips served as the chief legal and government affairs officer. From 1999 to 2004, Ms. Phillips practiced with the law firm of Stites & Harbison PLLC. In 1999, Ms. Phillips served as general counsel of Alexander for President, the presidential campaign of Senator Lamar Alexander. From 1995 to 1998, Ms. Phillips practiced with the law firm of Bass, Berry & Sims PLC. Ms. Phillips is a graduate of Auburn University, the Harvard Graduate School of Education and Harvard Law School.

Andrew W. McWilliams, Chief Accounting Officer . Mr. McWilliams joined the company as Chief Accounting Officer in August 2014. From October 1998 through August 2014, Mr. McWilliams worked as an auditor with Ernst & Young LLP, a national public accounting firm. During his tenure with Ernst & Young, Mr. McWilliams served multiple healthcare clients and also gained experience across a variety of corporate transactions, including public offerings of securities and mergers and acquisitions. Mr. McWilliams is a graduate of Georgia State University.

Darrell S. Freeman, Sr., Lead Independent Director . Mr. Freeman joined our Board of Directors in January 2013 and was appointed Lead Independent Director in June 2014. Mr. Freeman currently serves as the executive chairman of Zycron, Inc., an information technology services and solutions firm he founded in 1991. Mr. Freeman has served as the executive chairman of Zycron, Inc. since its formation in 1991. Mr. Freeman co-founded Tennessee-based Reliant Bank in 2006, and he has served as a board member and a member of the audit and compensation committees since 2006. Additionally, in 2007 Mr. Freeman co-founded Pinnacle Construction Partners, a construction management firm, and has served as the chairman since 2007. The Board of Directors believes that Mr. Freeman is qualified to serve as a director as a result of his extensive business and financial experience and insight into risk management from his experience co-founding Reliant Bank and his service on its audit committee. In 2012, Mr. Freeman was appointed to the Tennessee Board of Regents. Beginning in 2006, Mr. Freeman served two one-year terms as chairman of the Nashville Area Chamber of Commerce, and in 2005 served as the chairman of the 100 Black Men of Middle Tennessee. Mr. Freeman was also a founding board member of the Nashville Entrepreneur Center in 2010.

 

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Jerry D. Bostelman, Director . Mr. Bostelman joined our Board of Directors in July 2012. Mr. Bostelman is chief executive officer of Vaco, LLC, a professional staffing firm, which he co-founded in 2002. Prior to co-founding Vaco, Mr. Bostelman was a regional manager for Robert Half International Inc., a provider of staffing services for accounting and finance professionals, where he worked from 1997 through 2001. From 1993 through 1997, Mr. Bostelman served as an auditor for Arthur Anderson. The Board of Directors believes that Mr. Bostelman is qualified to serve as a director as a result of his accounting background and his broad management experience serving as regional manager of a national professional staffing firm. Mr. Bostelman served six years in the Marine Corps Reserves, including a five month active tour of duty in the first Gulf War.

Lucius E. Burch, III, Director. Mr. Burch joined our Board of Directors in February 2012. Since 1989, Mr. Burch has served as the chairman and chief executive officer of Burch Investment Group, formerly Massey Burch Investment Group. Mr. Burch began his tenure at Massey Investment Company (the predecessor of Massey Burch Investment Group), as a financial analyst and portfolio manager in 1968 and served as president from 1981 until 1989. Mr. Burch is also the chairman and chief executive officer of Collateral Guaranty, a credit enhancement fund. Mr. Burch is the former chairman of Corrections Corporation of America (NYSE:CXW), an operator of private prisons and detention centers and has served on numerous private and public company boards. The Board of Directors believes that Mr. Burch is qualified to serve as a director as a result of his extensive knowledge of and experience in the healthcare industry, his prior extensive board experience, including service on the Boards of Directors of seven New York Stock Exchange companies and his general business and financial acumen.

David C. Kloeppel, Director. Mr. Kloeppel joined our Board of Directors in April 2013. Mr. Kloeppel is chairman of Eventa Global, Inc., a travel services company he founded in 2014, and also serves as chief executive officer of Domus Hospitality, LLC, an operator of hotels in Latin American and the Caribbean he founded in 2013. Mr. Kloeppel served as president and chief operating officer of Gaylord Entertainment Company (NYSE:GET) from 2009 to 2012; as president and chief financial officer from 2008 to 2009; as executive vice president and chief financial officer from 2002 until 2008; and as chief financial officer from 2001 to 2002. Prior to joining Gaylord Entertainment Company he worked in the Mergers and Acquisitions Department at Deutsche Bank in New York, where he served as vice president and was responsible for that department’s activities in the lodging, leisure and real estate sectors. Mr. Kloeppel served as a director of FelCor Lodging Trust Inc. (NYSE:FCH) from 2005 to 2008, and was a member of the audit and compensation committees. The Board of Directors believes that Mr. Kloeppel is qualified to serve as a director as a result of his prior public company executive officer experience, his extensive corporate governance experience as an officer and director of publicly traded companies and his general business and financial acumen. Mr. Kloeppel currently serves on the Executive Committee of the Nashville Area Chamber of Commerce and the Board of Visitors of the Owen Graduate School of Management at Vanderbilt University. He is the current President of the Board of Trustees at University School of Nashville.

Richard E. Ragsdale, Director . Mr. Ragsdale joined our Board of Directors in July 2012. Mr. Ragsdale has co-founded and operated 17 healthcare corporations during his career. After beginning his career with Chase Manhattan Bank in New York, Mr. Ragsdale served as president and treasurer of Hospital Affiliates International, Inc., one of the country’s first hospital management firms, from 1973 to 1977, and served as vice president and chief financial officer of INA Health Care Group from 1977 to 1981. In 1981, he co-founded a hospital management company, Republic Health Corporation, which went public in 1983 and was acquired by an investor group in 1986. In 1985, Mr. Ragsdale co-founded Community Health Systems, Inc. (NYSE:CYH), a rural hospital management company, and served as chairman from 1985 to 1996. In 2000, he co-founded HealthMont Inc., an operator of community hospitals, and served as chairman from its formation in early 2000 until its acquisition by SunLink in October 2003. Mr. Ragsdale has served on the boards of numerous public and private companies and since June 2008, has served as a director of BreatheAmerica, Inc., an operator of allergy, asthma and sinusitis treatment centers. The Board of Directors believes that Mr. Ragsdale is qualified to serve as a director as a result of his extensive knowledge of and experience in the healthcare industry, his prior extensive public company board experience and his general business and financial acumen.

 

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Corporate Governance Profile

We have structured our corporate governance in a manner we believe closely aligns our interests with those of our stockholders. Notable features of our corporate governance structure include the following:

 

    our Board of Directors is not classified, with each of our directors subject to re-election annually;

 

    of the seven persons who serve on our Board of Directors, five of our directors satisfy the listing standards for independence of the NYSE and four of our directors satisfy the independence standards of Rule 10A-3 under the Exchange Act;

 

    each member of our Audit Committee qualifies as an “audit committee financial expert” as defined by the SEC;

 

    we intend to comply with the requirements of the NYSE listing standards, including having committees consisting solely of independent directors; and

 

    we do not have a stockholder rights plan.

Our directors will stay informed about our business by attending meetings of our Board of Directors and its committees and through supplemental reports and communications. Our independent directors meet regularly in executive sessions without the presence of our corporate officers or non-independent directors.

Board Leadership Structure

Our Board of Directors is currently chaired by our Chief Executive Officer, Mr. Cartwright. Our Board of Directors believes that combining the positions of Chief Executive Officer and Chairman helps to ensure that the Board of Directors and management act with a common purpose and provides a single, clear chain of command to execute our strategic initiatives and business plans. In addition, our Board of Directors believes that a combined Chief Executive Officer/Chairman is better positioned to act as a bridge between management and our Board of Directors, facilitating the regular flow of information. Our Board of Directors also believes that it is advantageous to have a Chairman with an extensive history with and knowledge of our company (as is the case with our Chief Executive Officer).

In June 2014, our Board of Directors appointed Mr. Freeman as lead independent director in connection with this offering in order to help reinforce the independence of our Board of Directors as a whole. The lead independent director will serve as an effective balance to a combined Chief Executive Officer/Chairman. The lead independent director is empowered to, among other duties and responsibilities, provide general leadership of the affairs of the independent directors, preside over board meetings in the absence of the Chairman and during independent director closed session portions of the meetings, preside over and establish the agendas for meetings of the independent directors and act as liaison between the Chairman and the independent directors.

Role of the Board in Risk Oversight

One of the key functions of our Board of Directors is informed oversight of our risk management process. Our Board of Directors administers this oversight function directly, with support from its three standing committees, the Audit Committee, the Compensation Committee and the Nominating and Corporate Governance Committee, each of which addresses risks specific to its respective areas of oversight. In particular, our Audit Committee has the responsibility to consider and discuss our major financial risk exposures and the steps our management has taken to monitor and control these exposures, including guidelines and policies to govern the process by which risk assessment and management is undertaken. The Audit Committee also monitors compliance with legal and regulatory requirements in addition to oversight of the performance of our internal audit function. Our Compensation Committee assesses and monitors whether any of our compensation policies and programs has the potential to encourage excessive risk-taking. Our Nominating and Corporate Governance Committee monitors the effectiveness of our corporate governance guidelines, including whether they are successful in preventing illegal or improper liability-creating conduct.

 

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Board Committees and Independence

The NYSE requires a majority of our Board of Directors to consist of independent directors. A director will only qualify as an “independent director” if, in the opinion of our Board of Directors, that person does not have a material relationship with the company that would interfere with the exercise of independent judgment. In addition, in order for a member of the Compensation Committee or the Audit Committee to be considered independent, such committee member may not, other than in his capacity as a member of the Board of Directors or any Board committee: (1) accept, directly or indirectly, any consulting, advisory, or other compensatory fee from us; or (2) be an affiliated person of us.

In March 2014, our Board of Directors undertook a review of the composition of our Board of Directors and its committees and the independence of each director. Based upon information requested from and provided by each director concerning his background, employment and affiliations, including family relationships, our Board of Directors has affirmatively determined that none of our directors other than Mr. Cartwright and Mr. Menz has a relationship that would interfere with the exercise of independent judgment in carrying out the responsibilities of a director and that each of our directors other than Mr. Cartwright and Mr. Menz is “independent” as that term is defined by the NYSE Listed Company Manual. Our Board of Directors also determined that Messrs. Freeman, Kloeppel and Ragsdale, who comprise our Audit Committee, Messrs. Burch, Kloeppel and Freeman, who comprise our Compensation Committee, and Messrs. Bostelman, Burch and Ragsdale, who comprise our Nominating and Corporate Governance Committee, each satisfy the independence standards for such committees established by the SEC and the NYSE. Each of the members of our Compensation Committee is an “outside director” for purposes of Section 162(m) of the Internal Revenue Code of 1986, as amended, or the Code, and a “non-employee director” for purposes of Rule 16b-3 under the Exchange Act. In making such determination, the Board of Directors considered the relationships that each such non-employee director has with our company and all other facts and circumstances the Board of Directors deemed relevant in determining independence, including the beneficial ownership of our capital stock by each non-employee director.

Board Committees

Our Board of Directors has established an Audit Committee, a Compensation Committee and a Nominating and Corporate Governance Committee. Each committee will operate under a charter approved by our Board of Directors. Following this offering, copies of each committee’s charter will be posted on the Corporate Governance section of our website, www.americanaddictioncenters.com .

Audit Committee . Our Audit Committee consists of Messrs. Freeman, Kloeppel and Ragsdale, each of whom is a non-employee director. Mr. Kloeppel serves as the chair of our Audit Committee. The functions of this committee include, among other things:

 

    evaluating the performance, independence and qualifications of our independent auditors and determining whether to retain our existing independent auditors or engage new independent auditors;

 

    reviewing and approving the engagement of our independent auditors to perform audit services and any permissible non-audit services;

 

    reviewing our annual and quarterly financial statements and reports and discussing the statements and reports with our independent auditors and management;

 

    reviewing with our independent auditors and management significant issues that arise regarding accounting principles and financial statement presentation, and matters concerning the scope, adequacy and effectiveness of our financial controls;

 

    reviewing with management and our auditors any earnings announcements and other public announcements regarding material developments;

 

    establishing procedures for the receipt, retention and treatment of complaints received by us regarding accounting, internal accounting controls or auditing matters and other matters;

 

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    preparing the report of the audit committee that the SEC requires in our annual proxy statement;

 

    overseeing risks associated with financial matters such as accounting, internal controls over financial reporting and financial policies;

 

    reviewing and providing oversight with respect to any related party transactions and monitoring compliance with our code of ethics; and

 

    reviewing and evaluating, at least annually, the performance of the Audit Committee, including compliance of the Audit Committee with its charter.

Our Board of Directors has determined that each member of the Audit Committee meets the financial literacy requirements under the NYSE listing standards and that each of Messrs. Kloeppel, Freeman and Ragsdale qualify as an “audit committee financial expert” within the meaning of SEC rules and regulations. In making its determination that each of Messrs. Kloeppel, Freeman and Ragsdale qualify as an “audit committee financial expert,” our Board of Directors has considered the formal education and nature and scope of the previous experience of each of Messrs. Kloeppel, Freeman and Ragsdale, coupled with past and present service on various Audit Committees. Both our independent registered public accounting firm and management personnel periodically meet privately with our Audit Committee.

Compensation Committee . Our Compensation Committee consists of Messrs. Freeman, Kloeppel and Burch. Mr. Burch serves as the chair of our Compensation Committee. The functions of this committee include, among other things:

 

    reviewing and recommending to our Board of Directors the compensation and other terms of employment of our executive officers;

 

    reviewing and recommending to our Board of Directors performance goals and objectives relevant to the compensation of our executive officers;

 

    evaluating and approving the equity incentive plans, compensation plans and similar programs advisable for us, as well as modification or termination of existing plans and programs;

 

    evaluating and recommending to our Board of Directors the type and amount of compensation to be paid or awarded to Board members;

 

    administering our equity incentive plans;

 

    reviewing and recommending to our Board of Directors policies with respect to incentive compensation and equity compensation arrangements;

 

    reviewing the competitiveness of our executive compensation programs and evaluating the effectiveness of our compensation policy and strategy in achieving expected benefits to us;

 

    evaluating and overseeing risks associated with compensation policies and practices;

 

    reviewing and recommending to our Board of Directors the terms of any employment agreements, severance arrangements, change in control protections and any other compensatory arrangements for our executive officers and other members of senior management;

 

    preparing the report of the compensation committee that the SEC requires in our annual proxy statement;

 

    reviewing the adequacy of its charter on an annual basis; and

 

    reviewing and evaluating, at least annually, the performance of the Compensation Committee, including compliance of the Compensation Committee with its charter.

 

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Nominating and Corporate Governance Committee. Our Nominating and Corporate Governance Committee consists of Messrs. Bostelman, Burch and Freeman. Mr. Freeman serves as the chair of our Nominating and Corporate Governance Committee. The functions of this committee include, among other things:

 

    identifying, reviewing and evaluating candidates to serve on our Board of Directors;

 

    determining the minimum qualifications for service on our Board of Directors;

 

    evaluating the performance of our Board of Directors and the committees thereof, including compliance of each committee with its charter;

 

    evaluating, nominating and recommending individuals for membership on our Board of Directors;

 

    considering nominations by stockholders of candidates for election to our Board of Directors;

 

    considering and assessing the independence of members of our Board of Directors;

 

    developing, as appropriate, a set of corporate governance principles, and reviewing and recommending to our Board of Directors any changes to such principles;

 

    periodically reviewing our policy statements;

 

    reviewing, at least annually, the adequacy of its charter; and

 

    evaluating, at least annually, the performance of the Nominating and Corporate Governance Committee, including compliance of the Nominating and Corporate Governance Committee with its charter.

Compensation Committee Interlocks and Insider Participation

No member of our Compensation Committee has ever been an executive officer or employee of ours. None of our officers currently serves, or has served during the last completed fiscal year, on the Compensation Committee or Board of Directors of any other entity that has one or more officers serving as a member of our Board of Directors or Compensation Committee. Prior to establishing the Compensation Committee, our full Board of Directors made decisions relating to compensation of our officers.

Code of Business Conduct and Ethics

Upon completion of this offering, our Board of Directors will establish a code of business conduct and ethics that applies to our officers, directors and employees. Among other matters, our code of business conduct and ethics will be designed to deter wrongdoing and to promote:

 

    honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional relationships;

 

    full, fair, accurate, timely and understandable disclosure in our SEC reports and other public communications;

 

    compliance with applicable laws, rules and regulations;

 

    prompt internal reporting of violations of the code to appropriate persons identified in the code; and

 

    accountability for adherence to the code of business conduct and ethics.

Any waiver of the code of business conduct and ethics for our executive officers or directors must be approved by a majority of our independent directors, and any such waiver shall be promptly disclosed as required by law or NYSE regulations. Following this offering, a current copy of the code will be posted on the Corporate Governance section of our website, www.americanaddictioncenters.com .

 

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Director Compensation

As compensation for serving on our Board of Directors, we intend to provide each of our independent directors an annual retainer consisting of a stock award with a grant date fair value of $40,000. In addition, we have historically paid each of our independent directors a fee of $2,000 in cash per meeting. Directors who are also officers or employees of our company will receive no additional compensation for service as directors. In addition, we will reimburse our directors for their reasonable out-of-pocket expenses incurred in attending Board of Directors and committee meetings. The following table reflects the total compensation earned by our non-employee directors in 2013:

 

Name

   Fees earned or
paid in cash

($)
     Stock
Awards
($) (1)
     Total
($)
 

Jerry D. Bostelman

     12,000         47,378         59,378   

Lucius E. Burch, III

     10,000         47,378         57,378   

Darrell S. Freeman, Sr.

     10,000         47,378         57,378   

David C. Kloeppel

     8,000         47,378         55,378   

Richard E. Ragsdale

     12,000         47,378         59,378   

 

(1) Reflects the aggregate grant date fair value, computed in accordance with Financial Accounting Standards Board Accounting Standards Codification Topic 718, of a March 2014 grant of 3,713 fully vested shares of common stock to each non-employee director as compensation for his service to AAC in 2013. See Note 12 titled “Stock-Based Compensation Plans” to our audited consolidated financial statements included elsewhere in this prospectus for a discussion of the assumptions made by us in determining the grant date fair value of our equity awards.

 

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EXECUTIVE COMPENSATION

Overview

The primary goal of our executive compensation program is to align executive compensation with our business objectives and individual performance, as well as to enable us to attract, retain and reward executive officers who contribute to our long-term success. The Compensation Committee sets the compensation of our executive officers. Generally, the committee considers and evaluates the company’s performance and goals and our Chief Executive Officer’s recommendations with respect to each officer (other than the Chief Executive Officer) in setting compensation. The compensation of our executive officers consists of a combination of base salary and annual incentive bonuses paid in cash or equity. All employees, including our executive officers, also receive a benefits package.

As an “emerging growth company,” we have opted to comply with the executive compensation disclosure rules applicable to “smaller reporting companies” as such term is defined in the rules promulgated under the Securities Act, which require compensation disclosure for our Chief Executive Officer and the two most highly compensated executive officers other than our Chief Executive Officer, whom we collectively refer to as our “named executive officers” in this prospectus.

2013 Summary Compensation Table

The following table provides information regarding the compensation earned by our named executive officers during the year ended December 31, 2013.

 

Name and Principal Position

   Year      Salary
($)
     Bonus
($)
     Stock
Awards
($)
    All Other
Compensation

($)
    Total
($)
 

Michael T. Cartwright

     2013         635,000         1,270,000                23,177 (1)       1,928,177   

Chairman and Chief

Executive Officer

               

Jerrod N. Menz

     2013         480,000         864,000                30,786 (2)       1,374,786   

President

               

Candance A. Henderson-Grice (3)

     2013         238,236         105,000         472,887 (4)       95,907 (5)       912,030   

Chief Operating Officer

               

 

(1) Reflects $20,177 of payments for health insurance premiums and $3,000 of company contributions to a health savings account (HSA).

(2) Reflects $20,177 of payments for health insurance premiums, $7,609 of company contributions to the company’s 401(k) profit sharing plan and $3,000 of company contributions to an HSA.

(3) Ms. Henderson-Grice joined the company in February 2013.

(4) Reflects the aggregate grant date fair value, computed in accordance with Financial Accounting Standards Board Accounting Standards Codification Topic 718, of a November 2013 grant of 46,407 shares of restricted common stock, which vests in four equal installments on December 31, 2013, March 31, 2014, June 30, 2014 and September 30, 2014. See Note 12 titled “Stock-Based Compensation Plans” to our audited consolidated financial statements included elsewhere in this prospectus for a discussion of the assumptions made by us in determining the grant date fair value of our equity awards.

(5) Reflects $79,467 of additional cash compensation to satisfy the personal tax obligation related to the restricted stock awards, $1,763 of company contributions to the company’s 401(k) profit sharing plan, $11,677 of health insurance premiums and $3,000 of company contributions to an HSA.

2013 Executive Compensation Elements

Each of our named executive officers was provided with the following material elements of compensation in 2013:

Base Salary. We provide a base salary to each named executive officer. The primary goal for base salary is to be market competitive and to compensate an executive’s short-term contributions, as well as to provide current financial stability.

 

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Annual Incentive Awards. Annual bonuses are a key component of our executive compensation strategy and represented a majority of the total compensation paid to our named executive officers in 2013. In August 2013, the Compensation Committee engaged McDaniel & Associates as its independent compensation consultant to advise the Company on its executive compensation program, including by identifying a peer group of companies and performing a peer group compensation analysis. The peer group recommended by McDaniel & Associates and utilized by the Compensation Committee for 2013 compensation purposes consisted of 16 publicly traded health care organizations, with annual revenues ranging from $86 million to slightly over $400 million. The companies comprising our 2013 peer group were as follows:

 

Acadia Healthcare Company, Inc.

   HealthStream, Inc.

AdCare Health Systems, Inc.

   IntegraMed America, Inc.

Addus Homecare Corporation

   LCA-Vision Inc.

Almost Family, Inc.

   MedCath Corporation

Arcadia Resources, Inc.

   National Research Corporation

Assisted Living Concepts, Inc.

   NovaMed, Inc.

Capital Senior Living Corporation

   SunLink Health Systems, Inc.

Diversicare Healthcare Services, Inc.

   USMD Holdings, Inc.

After reviewing the analysis and recommendations of McDaniel & Associates and taking into account the individual circumstances of each named executive officer, the Compensation Committee approved the target and maximum level of annual incentive bonuses for fiscal year 2013 with respect to each named executive officer. With respect to Michael Cartwright, our Chairman and Chief Executive Officer, and Jerrod Menz, our President, the Compensation Committee determined that their compensation should consist primarily of annual cash incentives because each already owned a substantial amount of equity in the Company. Therefore, the target annual cash incentive award was set at 100% of base salary for Mr. Cartwright and 80% of base salary for Mr. Menz, with proposed maximums of 200% and 160%, respectively, of base salary upon outstanding company and individual performance. With respect to Candance Henderson-Grice, our Chief Operating Officer, the Compensation Committee set her target annual incentive compensation at 60% of her annualized base salary, with a proposed maximum of 160% of annualized base salary upon outstanding company and individual performance. The Compensation Committee retained the ability to apply its discretion to any and all such awards, and it did not set specific performance targets upon which the bonuses would become payable.

The annual incentive bonuses actually awarded to each named executive officer in respect of 2013, including the positive discretion with respect to the bonuses of Mr. Menz and Ms. Henderson-Grice, were ultimately based on a discretionary performance evaluation conducted by our Compensation Committee and Chief Executive Officer, in consultation with other executive officers. The determination involved an analysis of both (i) the Company’s overall performance, including significant growth in revenues in 2013 and (ii) the performance of the individual officer and his or her contributions to the Company. With respect to Ms. Henderson-Grice, in light of her joining the company in February 2013, the Compensation Committee determined that her annual incentive award should be paid primarily as an award of restricted stock to help align her personal long-term interests with our stockholders. Therefore, Ms. Henderson-Grice was awarded a grant of 46,407 restricted shares in November 2013.

Employment Agreements. We currently do not have any employment agreements with our named executive officers.

Retirement Arrangements. We maintain a 401(k) savings plan for eligible employees, including our named executive officers, and provide annual discretionary matching contributions to 401(k) plan participants. We do not maintain a defined benefit pension plan.

Employee Benefits. Eligible employees, including our named executive officers, participate in broad-based and comprehensive employee benefit programs, including medical, dental, vision, life and disability insurance. Our named executive officers participate in these programs on the same basis as eligible employees generally, except that the company covers the full costs of premiums with respect to the medical insurance plan.

 

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Outstanding Equity Awards at 2013 Fiscal Year-End

The following table provides information with respect to holdings of unvested restricted stock awards held by our named executive officers at December 31, 2013.

 

           Stock Awards  

Name

   Grant
Date
    Number of
Shares or Units
of Stock That
Have Not Vested

(#)
     Market Value of
Shares or Units
of Stock That
Have Not Vested

($) (1)
 

Michael T. Cartwright

                      

Jerrod N. Menz

                      

Candance A. Henderson-Grice

     11/19/2013 (2)       34,806      

 

(1) The market price for our common stock is based upon the assumed initial public offering price of $         per share, which is the midpoint of the estimated offering price range set forth on the cover page of this prospectus.

(2) Reflects restricted stock that vests in three equal installments on March 31, 2014, June 30, 2014 and September 30, 2014.

2014 Executive Compensation Elements

The Compensation Committee determined the following with respect to our 2014 executive compensation program, which includes the compensation of our named executive officers:

 

    No Change in Base Salaries: The Compensation Committee determined that there were no increases in base salaries for the named executive officers for 2014. As a result, the 2014 base salaries of our named executive officers will remain the same as disclosed in the 2013 Summary Compensation Table above, except Candance A. Henderson-Grice’s base salary will be reflective of a full year of service ($300,000).

 

    2014 Annual Cash Incentive Plan: For 2014 the Compensation Committee approved the 2014 Cash Incentive Plan for certain eligible employees, including our named executive officers. The 2014 Cash Incentive Plan target and maximum bonus amounts for our named executive officers are set forth below.

 

Executive Officer

   2014 Base
Salary
     2014 Target
Bonus
(as a percentage
of base salary)
    2014 Maximum
Bonus
(as a percentage
of base salary)
 

Michael T. Cartwright

   $ 635,000         100     200

Jerrod N. Menz

   $ 480,000         80     160

Candance A. Henderson-Grice

   $ 300,000         60     120

Bonus awards payable pursuant to the 2014 Cash Incentive Plan with respect to our “Senior Officer Participants,” defined to include Mr. Cartwright, Mr. Menz and Kirk Manz, our Chief Financial Officer, will be calculated based on the Company’s achievement of adjusted EBITDA targets during each quarter of the 2014 fiscal year and the 2014 fiscal year as a whole. The definition of adjusted EBITDA under the 2014 Cash Incentive Plan is consistent with the definition of adjusted EBITDA under our Credit Facility. (For additional information, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Financing Relationships.”) In order for the Senior Officer Participant to qualify for an award with respect to any quarter, the Company must meet the respective adjusted EBITDA target for such quarter. If the adjusted EBITDA target for a quarter is met, the executive will be entitled to an award in an amount up to 25% of the target bonus amount for such executive. If the adjusted EBITDA target for a quarter is not met, the executive will not be entitled to an award for such quarter (except for any year-end adjustment as described below). If the Company achieves or exceeds the adjusted EBITDA target with respect to the 2014 fiscal year, the executive will be entitled to an award with respect to the fiscal year according to the following formula: (a) the percentage of

 

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the adjusted EBITDA target that actual adjusted EBITDA for the 2014 fiscal year represents, multiplied by (b) the executive’s target bonus amount, with the product of (a) and (b) reduced (but not below zero) by (c) payments made during the fiscal year with respect to the achievement of the adjusted EBITDA target with respect to each fiscal quarter; provided, that no executive will be entitled to receive more than such executive’s maximum bonus as described above.

With respect to our other executive officers, including Ms. Henderson-Grice, awards will be based on the officer’s achievement of individual goals during each quarter as established by Mr. Cartwright. If the officer meets his or her individual goals with respect to the quarter, the officer will be entitled to an award equal to 25% of his or her target bonus for the year.

Benefit Plans

2007 Stock Incentive Plan

We adopted our 2007 Stock Incentive Plan, or the 2007 Plan, to enable us to attract, retain and reward employees, officers, directors and consultants of us and our affiliates for their services and to motivate such individuals through added incentives to further contribute to our success and the success of our affiliates. Of the 2,500,000 shares of common stock that were eligible for issuance pursuant to awards made under the 2007 Plan, no shares of common stock were subject to outstanding restricted stock awards as of December 31, 2013, other than 69,612 shares previously granted to three of our officers in November 2013, one-third of which vested on each of March 31, 2014 and June 30, 2014 with the remaining portion vesting on September 30, 2014. Although the 2007 Plan remains in effect for awards granted under the 2007 Plan, we will not make any additional awards under the 2007 Plan.

2014 Equity Incentive Plan

In connection with this offering, we have adopted the 2014 Equity Incentive Plan, or 2014 Plan. The purpose of the 2014 Plan is to attract and retain key officers, employees, directors and consultants, motivate such individuals by means of performance-related incentives to achieve long-range performance goals, enable such individuals to participate in our long-term growth and financial success, encourage ownership of our stock by such individuals, and link such individuals’ compensation to the long-term interests of us and our stockholders. The 2014 Plan is also designed to permit us to make cash-based awards and equity-based awards intended to qualify as “performance-based compensation” under Section 162(m) of the Internal Revenue Code of 1986, as amended, or the Code.

This following summary is qualified in its entirety by reference to the text of the 2014 Plan, which is filed as an exhibit to the registration statement of which this prospectus is a part.

Eligibility . Awards may be granted under the 2014 Plan to employees (including officers), directors (including non-employee directors) and consultants of our company or any of our subsidiaries or other affiliates. Only employees of us or any of our subsidiaries or other affiliates are eligible to receive incentive stock options.

Administration, Amendment and Termination . Our Compensation Committee will have the power and authority to administer the 2014 Plan. The Compensation Committee will have the authority to interpret the terms and intent of the 2014 Plan, determine eligibility for and terms of awards for participants and make all other determinations necessary or advisable for the administration of the 2014 Plan. To the extent permitted by the terms of the 2014 Plan, the Compensation Committee charter, and applicable law, our Compensation Committee may delegate certain authority under the 2014 Plan to one or more officers or managers of us or any affiliate, or to a committee of such officers or managers under terms and limitations the Compensation Committee may establish.

 

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Our Board of Directors may amend, alter, suspend, discontinue or terminate the 2014 Plan at any time. No such action may be taken without the approval of stockholders if such approval is necessary to comply with any tax or regulatory requirement for which or with which the Board of Directors deems it necessary or desirable to comply. Furthermore, subject to the 2014 Plan’s repricing restrictions, the Compensation Committee may waive any conditions or rights under, amend any terms of or alter, suspend, discontinue, cancel or terminate, any award granted under the 2014 Plan, prospectively or retroactively, provided that any such action that would materially and adversely affect the rights of any participant or any holder or beneficiary of any such award shall not to that extent be effective without consent.

Awards . Awards under the 2014 Plan may be made in the form of options, stock appreciation rights, restricted share awards, restricted share units, performance awards, other stock-based awards or any other rights, interest or options relating to shares or other property (including cash), whether singly, in combination, or in tandem.

Shares Subject to the Plan . Following this offering, the aggregate number of shares of our common stock that may be issued initially pursuant to awards under the 2014 Plan is 1,000,000 shares. The maximum number of shares that may be issued pursuant to the exercise of incentive stock options under the 2014 Plan is 1,000,000 shares. No more than 200,000 shares may be issued to any participant during any single calendar year with respect to options and stock appreciation rights. With respect to any “covered employee,” as defined in Section 162(m) of the Code, the maximum annual number of shares in respect of which all performance awards may be granted under the 2014 Plan is 150,000 and the maximum amount of cash-settled performance awards that may be granted under the 2014 Plan in any year is $3,000,000. Shares issued under the 2014 Plan may be authorized but unissued shares or treasury shares. Any shares covered by an award, or portion of an award, granted under the 2014 Plan that are forfeited or canceled, expires or are settled in cash shall again be available for issuance under the 2014 Plan. In the event that withholding tax liabilities arising from an award other than an option or stock appreciation right are satisfied by the tendering of shares or by the withholding of shares by us, the shares so tendered or withheld shall again be available for issuance under the 2014 Plan. Shares that are issued in connection with substitute awards will not reduce the shares available for awards under the 2014 Plan or count against any limits otherwise set forth in the 2014 Plan.

Non-Employee Director Awards . The Board of Directors may provide that all or a portion of a nonemployee director’s annual retainer, meeting fees and/or other awards or compensation as determined by the Board of Directors, be payable (either automatically or at the election of a non-employee director) in the form of non-qualified stock options, restricted shares, restricted share units and/or other stock-based awards under the 2014 Plan, including unrestricted shares. The Board of Directors shall determine the terms and conditions of any such awards, including the terms and conditions which shall apply upon a termination of the non-employee director’s service as a member of the Board of Directors, and shall have full power and authority in its discretion to administer such awards, subject to the terms of the 2014 Plan and applicable law.

Adjustment of Shares Subject to the Plan . In the event of certain changes in our capitalization, the Compensation Committee will adjust, among other award terms, the number and class of shares, other securities or other property that may be delivered in connection with awards and the exercise price, grant price or purchase price relating to any award in such manner as the Compensation Committee determines to be appropriate in an equitable and proportionate manner. Furthermore, the Compensation Committee will adjust the aggregate number and class of shares or other securities (or the number and kind of other property) with respect to which awards may be granted under the 2014 Plan.

Effect of a Change in Control . The discussion below of the effects of a change in control (as defined in the 2014 Plan) applies to outstanding awards unless otherwise provided in an award agreement. In the event of a change in control, if the successor company does not assume or substitute (or continue) outstanding awards, the awards immediately vest and, in the case of options and SARs, become fully exercisable. If outstanding awards are assumed or substituted (or continued) and a participant’s employment terminates within 24 months after a

 

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change in control (or such other period specified in the award agreement), except to the extent otherwise provided in any award agreement, outstanding awards immediately vest and, in the case of options and SARs, become fully exercisable.

In its discretion, the Compensation Committee may provide that in the event of a change in control (i) outstanding stock options and SARs will terminate within a specified number of days after notice to participants, (ii) participants will receive a payment (in cash, stock or other property) equal to the excess of the fair market value of the common stock immediately prior to the change in control over the exercise price or grant price, as applicable, of the options and SARs, and/or (iii) cancel without payment outstanding stock options and SARs if the fair market value of the common stock as of the change in control date is less than the exercise price of the options and SARs. In its discretion, the Committee may also further provide that in the event of a change in control all performance awards will be considered to be earned and payable (either in full or pro rata based on the portion of performance period completed as of the date of the change in control), and any limitations or other restrictions will lapse and such performance awards will be immediately settled or distributed.

Qualified Performance-Based Compensation . Section 162(m) of the Code limits public companies to an annual deduction for federal income tax purposes of $1,000,000 for compensation paid to their Chief Executive Officer and, based on recent IRS interpretation, the three most highly compensated executive officers, other than the Chief Executive Officer and Chief Financial Officer, determined at the end of each year. Qualified performance-based compensation is excluded from this limitation. The 2014 Plan is designed to permit the Compensation Committee to grant performance awards that qualify as performance-based compensation for purposes of satisfying the conditions of Section 162(m) at such time as the 2014 Plan becomes subject to Section 162(m); provided that our stockholders approve the 2014 prior to the end of the Transition Period, as described below. The Compensation Committee may select performance targets based on one or more of the following performance measures relating to us, our subsidiaries, our operating units, our business segments or our divisions: total sales or revenues; sales or revenue per employee; earnings before interest, taxes, depreciation and/or amortization; operating income or profit (before or after taxes); operating margins, gross margins or cash margin; operating efficiencies; return on equity, assets (or net assets), capital, capital employed or investment; net income (before or after taxes); pre- or after-tax income (before or after allocation of corporate overhead and bonuses); earnings (gross, net, pre-tax, after tax or per share); utilization; improvement in or attainment of expense levels or working capital levels, including cash, inventory and accounts receivable; gross or net profit margins; stock price or total stockholder return; cash flow or cash flow per share (before or after dividends); appreciation in and/or maintenance of the price of shares or other publicly-traded securities of the Company; client growth or sales; debt reduction; year-end cash; financial ratios, including those measuring activity, leverage, liquidity or profitability; cost of capital or assets under management; financing and other capital-raising transactions; revenue; market share; strategic business objectives, consisting of one or more objectives based on meeting specified cost targets, business expansion goals or goals relating to acquisitions or divestitures; or any combination thereof. Each performance target may be expressed on an absolute and/or relative basis, may be based on or otherwise employ comparisons based on internal targets, the past performance of us or any subsidiary, operating unit, business segment or division of us and/or the past or current performance of other companies, and in the case of earnings-based measures, may use or employ comparisons relating to capital, stockholders’ equity and/or shares outstanding, or to assets or net assets. The Compensation Committee may appropriately adjust any evaluation of performance under criteria set forth in the 2014 Plan and may make downwards adjustments to the amounts payable pursuant to a performance award.

The Treasury Regulations under Section 162(m) of the Code provide that, in the case of a corporation that was not a publicly held corporation and then becomes a publicly held corporation, the $1,000,000 deduction limit does not apply to any remuneration paid pursuant to a compensation plan or agreement that existed during the period in which the corporation was not publicly held. A corporation may rely on this transition rule during the Transition, Period, which ends upon the earliest of: (i) the expiration of the plan or agreement; (ii) the material modification of the plan or agreement; (iii) the issuance of all employer stock and other compensation that has been allocated under the plan; or (iv) the first meeting of stockholders at which directors are to be elected

 

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that occurs after the close of the third calendar year following the calendar year in which the initial public offering occurs or, in the case of a privately held corporation that becomes publicly held without an initial public offering, the first calendar year following the calendar year in which the corporation becomes publicly held. The transition relief applies to any compensation received pursuant the exercise of an option or a stock appreciation right, or the substantial vesting of restricted property, if the grant occurs on or before the end of the Transition Period. We will utilize the transition relief provided pursuant to Section 162(m) of the Code to the extent our Board of Directors, in its discretion, determines appropriate.

Limitations on Directors’ Liability and Indemnification Agreements

Our articles of incorporation, which will become effective upon the closing of this offering, limit the liability of directors to the maximum extent permitted by Nevada law. With the exception of limited circumstances, Nevada law provides that directors of a Nevada corporation will not be personally liable to the corporation or its stockholders or creditors for any damages as a result of any act or failure to act in his or her capacity as a director unless it is proven that:

 

    the director’s act or failure to act constituted a breach of fiduciary duty; and

 

    the breach involved intentional misconduct, fraud, or a knowing violation of law.

Our articles of incorporation do not eliminate a director’s duty of care and, in appropriate circumstances, equitable remedies, such as injunctive or other forms of non-monetary relief, remain available under Nevada law. These limitations also do not affect a director’s responsibilities under any other laws, such as the federal securities laws or other state or federal laws. Our bylaws, which will become effective upon the closing of this offering, provide that we will indemnify our directors and officers, and may indemnify other officers, employees and other agents, to the fullest extent permitted by law. Our bylaws also provide that we are obligated, subject to certain conditions, to advance expenses incurred by a director or officer in advance of the final disposition of any action or proceeding and also permit us to secure insurance on behalf of any officer, director, employee or other agent for any liability asserted against such person and incurred by such person in any such capacity, or arising out of his or her status as such, regardless of whether our bylaws permit such indemnification. We have obtained a directors’ and officers’ liability insurance policy.

We have entered, and intend to continue to enter, into separate indemnification agreements with our directors and officers, in addition to the indemnification provided for in our articles of incorporation and bylaws. These agreements, among other things, require us to indemnify our directors and officers for certain expenses, including attorneys’ fees, judgments, fines and settlement amounts incurred by a director or officer in any action or proceeding arising out of their services as one of our directors or officers, or any of our subsidiaries or any other company or enterprise to which the person provides services at our request. We believe that these articles of incorporation and bylaw provisions and indemnification agreements are necessary to attract and retain qualified persons as directors and officers.

The limitation of liability and indemnification provisions in our articles of incorporation and bylaws may discourage stockholders from bringing a lawsuit against directors for breach of their fiduciary duties. These provisions may also reduce the likelihood of derivative litigation against directors and officers, even though an action, if successful, might benefit us and our stockholders. A stockholder’s investment may be harmed to the extent we pay the costs of settlement and damage awards against directors and officers pursuant to these indemnification provisions.

At present, there is no pending litigation or proceeding involving any of our directors or officers as to which indemnification is required or permitted, and we are not aware of any threatened litigation or proceeding that may result in a claim for indemnification.

 

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CERTAIN RELATIONSHIPS AND RELATED PARTY TRANSACTIONS

Reorganization Transactions

Private Share Exchange

The following table sets forth the total number of Holdings shares received by certain of our directors, executive officers and other related persons and their affiliates in connection with the Private Share Exchange effected in April 2014, whereby holders representing 93.6% of the outstanding shares of common stock of AAC exchanged their shares on a one-for-one basis for shares of Holdings common stock:

 

Name

  

Relationship with Us

   Number of Holdings Shares
Received in the
Private Share Exchange

Michael T. Cartwright

   Chief Executive Officer and Chairman of the Board    2,899,243

Jerrod N. Menz

   President and Director    2,545,746

Kirk R. Manz

   Chief Financial Officer    258,273

Candance A. Henderson-Grice

   Chief Operating Officer    26,241

Kathryn Sevier Phillips

   General Counsel and Corporate Secretary    32,585

Jerry D. Bostelman

   Director    374,969

Lucius E. Burch, III

   Director    669,381

Darrell S. Freeman, Sr.

   Director    99,731

David C. Kloeppel

   Director    125,220

Richard E. Ragsdale

   Director    34,090

Tina F. Cartwright

   Spouse of Michael T. Cartwright    607,533

Victoria Menz

   Spouse of Jerrod N. Menz    607,533

BHR Acquisition

In connection with the BHR Acquisition, Holdings acquired 100% of the outstanding common membership interests in BHR, 45% of which were held by our CEO, 45% of which were held by our President and 10% of which were held by our CFO. Mr. Cartwright received total consideration of $4.5 million, consisting of $1.5 million in cash and 223,714 shares of Holdings common stock, at a fair value of $13.41 per share. Mr. Menz received total consideration of $4.5 million, consisting of $1.5 million in cash, a portion of which he used to fully repay an outstanding note receivable in the amount of $250,000 between himself and AAC, and 223,714 shares of Holdings common stock, at a fair value of $13.41 per share. Mr. Manz received total consideration of $1.0 million, consisting of $3 in cash and 74,571 shares of Holdings common stock, at a fair value of $13.41 per share.

Also in connection with the BHR Acquisition, Holdings assumed and refinanced a $1.8 million term loan that was previously the joint obligation of Messrs. Cartwright, Menz and Manz and guaranteed by AAC. This term loan was entered into in October 2013 by Messrs. Cartwright, Menz and Manz in the amount of $1.9 million with a financial institution. The original proceeds from the term loan were used to repay a loan of Greenhouse Real Estate, LLC, a BHR subsidiary. Messrs. Cartwright, Menz and Manz remain guarantors of this term loan after the BHR Acquisition and Holdings has been added as a borrower and guarantor of this term loan. We intend to repay the outstanding balance of this term loan in connection with this offering.

CRMS Acquisition

In connection with the CRMS Acquisition, Holdings acquired 100% of the outstanding membership interests in CRMS, 50% of which were held by Tina F. Cartwright, the spouse of our CEO, and 50% of which were held by Victoria Menz, the spouse of our President, for total consideration of $0.5 million and 149,144 shares of Holdings common stock. Ms. Cartwright received total consideration of $1.3 million, consisting of $250,000 in cash and 74,572 shares of Holdings common stock at a fair value of $13.41 per share. Ms. Menz received total consideration of $1.3 million, consisting of $250,000 in cash and 74,572 shares of Holdings common stock at a fair value of $13.41 per share.

 

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For additional information related to the Reorganization Transactions, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and Note 3 to our unaudited condensed consolidated financial statements included elsewhere in this prospectus.

BHR Series A Preferred Units

From November 2013 through February 2014, BHR sold 36.5 Series A Preferred Units, valued at $50,000 per unit, to certain accredited investors. In connection with these transactions, Jerry D. Bostelman, one of our directors, purchased five Series A Preferred Units for $250,000 and an entity controlled by Gloria J. Freeman, the spouse of one of our directors, purchased four Series A Preferred Units for $200,000.

BHR Series A Preferred Units Redemption

To help facilitate the Reorganization Transactions, BHR redeemed all of the outstanding Series A Preferred Units (36.5 units) from certain accredited investors in April 2014. As part of this redemption, Jerry D. Bostelman, one of our directors, received $250,000 and an entity controlled by Gloria J. Freeman, the spouse of one of our directors, received $200,000. The proceeds from such redemptions were used to purchase an aggregate of 35,285 shares of AAC common stock at a price of $12.76 per share.

Earlier Financing Transactions

Prior to the Reorganization Transactions described above, AAC was the ultimate parent company of our business and all previous financing transactions were effected through AAC, including the following financing transactions concluded since 2011:

 

    From February through April 2014, AAC issued 471,843 shares of common stock to certain accredited investors at a price of $12.76 per share, for aggregate offering proceeds of $6.0 million (the “2014 Offering”); and

 

    In March and April 2013, AAC issued 918,589 shares of common stock to certain accredited investors at a price of $8.23 per share, for aggregate offering proceeds of $7.5 million (the “2013 Offering”).

The following table summarizes the participation by our officers, directors and their affiliates in the previous AAC financing transactions described above:

 

          2013 Offering      2014 Offering  

Name

  

Relationship with Us

   Shares      Aggregate
Consideration
Paid to AAC
     Shares      Aggregate
Consideration
Paid to AAC
 

Michael T. Cartwright (1)

   Chief Executive Officer and Chairman of the Board      182,260       $ 1,500,000                   

Kirk Manz

   Chief Financial Officer      3,038       $ 25,000                   

Candance Henderson-Grice (2)

   Chief Operating Officer      3,038       $ 25,000         3,918       $ 49,994   

Kathryn Sevier Phillips

   General Counsel and Secretary                      7,837       $ 100,000   

Michael Blackburn (3)

   Vice President      60,753       $ 500,000                   

Adam Mittelberg

   Vice President      3,038       $ 25,000         1,959       $ 25,000   

Jerry D. Bostelman

   Director      243,014       $ 2,000,000         39,184       $ 250,000   

Darrell S. Freeman, Sr. (4)

   Director      60,753       $ 500,000         35,265       $ 449,981   

David C. Kloeppel

   Director      121,507       $ 1,000,000                   

Richard E. Ragsdale

   Director      30,377       $ 250,000                   

 

 

(1) Mr. Cartwright converted a $1.5 million promissory note as consideration for the shares purchased in the 2013 Offering. See “AAC Related Party Debt” below.
(2) The shares presented as beneficially owned by Ms. Henderson-Grice include 3,918 purchased in the 2014 Offering by Alan Grice, Ms. Henderson-Grice’s spouse, through a retirement account controlled by Mr. Grice.

 

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(3) Mr. Blackburn converted a $0.5 million promissory note as consideration for the shares purchased in the 2013 Offering. See “Other Relationships and Transactions—TSN Acquisition” below.
(4) The shares presented as beneficially owned by Mr. Freeman include 60,754 shares purchased in the 2013 Offering by Zycron, Inc., a corporation that Mr. Freeman controls and 15,673 shares purchased in the 2014 Offering by Milan Investment Group, LLC, an entity controlled by Gloria J. Freeman, Mr. Freeman’s spouse.

AAC Related Party Debt

On April 15, 2014, AAC entered into a Second Amended and Restated Credit Facility with Wells Fargo Bank, National Association. Mr. Cartwright, our CEO, and Mr. Menz, our President, jointly and severally guarantee the Credit Facility.

In November 2012, Mr. Cartwright loaned AAC $1,500,000 and was issued a promissory note that bore interest at 12%, which interest was payable in arrears monthly. In April 2013, Mr. Cartwright converted the entire $1.5 million principal balance of this promissory note into shares of AAC common stock at a conversion price per share of $8.23. The amount of interest paid from November 2012 through April 2013 with respect to this promissory note was $90,000 and no principal payments were made during this period. For additional information related to this conversion, see “Earlier Financing Transactions” above.

In March 2012, Mr. Bostelman, one of our directors, purchased $200,000 in aggregate principal amount of subordinated promissory notes, which mature in full on March 31, 2017. In connection with this transaction, Mr. Bostelman received a warrant to purchase 15,095 shares of AAC common stock at $1.00 per share, which he exercised in full in March 2014. As of June 30, 2014, the outstanding principal amount of Mr. Bostelman’s subordinated promissory notes was $200,000. The amount of interest paid from March 2012 to June 30, 2014 with respect to these subordinated promissory notes was $57,403 and no principal payments were made during this period.

As of December 31, 2013, 2012 and 2011, AAC had a note outstanding from Mr. Menz with a principal balance of $250,000. This note was repaid in full by Mr. Menz to AAC on April 15, 2014. No principal and interest was paid during 2011, 2012 and 2013 with respect to this note receivable. In addition, as of June 30, 2014, AAC had a non-interest bearing receivable from Mr. Menz of $390,000. The balance of this non-interest bearing receivable will be repaid in full by Mr. Menz to AAC prior to the completion of this offering.

In April 2011, we entered into an agreement with Josephine Gann, a former stockholder and director of Forterus, Inc. for the repurchase of common and preferred shares held by Ms. Gann. Under the terms of the agreement we issued a $0.6 million subordinated note to the stockholder and agreed to make other payments totaling $0.2 million to or on behalf of the stockholder in exchange for 526,247 shares of common stock, 100,000 shares of Series B Preferred Stock and 656,586 shares of Series C Preferred Stock of a predecessor entity of AAC. The balance of the note was fully paid in the second quarter of 2013. The amounts of principal and interest paid from April 2011 to June 2013 with respect to this subordinated note were $554,098 and $55,902, respectively.

BHR Transactions

Concorde Real Estate, LLC

In conjunction with the consolidation of Concorde Real Estate, LLC (“Concorde Real Estate”) on June 27, 2012, AAC assumed a $3.5 million promissory note that was refinanced and increased in July 2012 to loans totaling $7.4 million in two tranches. The additional debt in 2012 resulted from borrowings to complete the renovation of the Desert Hope facility. The amount outstanding under the first tranche was $4.4 million at December 31, 2012. The amount outstanding under the second tranche was $3.0 million at December 31, 2012. In May 2013, Concorde Real Estate refinanced these two outstanding loans with a $9.6 million note. The additional debt was used to redeem the outstanding preferred membership interests in Concorde Real Estate. The

 

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amount outstanding under this note at June 30, 2014 was $8.9 million. The amounts of principal and interest paid from June 2013 to June 30, 2014 were $645,688 and $265,971, respectively. The note is guaranteed by AAC, Mr. Carwright, our CEO, and Mr. Menz, our President.

Greenhouse Real Estate, LLC

Greenhouse Real Estate, LLC (“Greenhouse Real Estate”) entered into a $13.2 million construction loan facility with a financial institution on October 8, 2013 to refinance existing debt related to a 70-bed facility located in Grand Prairie, Texas and to fund the construction of an additional 60 beds at this facility. At June 30, 2014, the outstanding balance of the construction loan facility was $12.5 million. The amount of interest paid from October 2013 to June 30, 2014 was $209,708 and no principal payments were made during this period. In August 2014, we converted the construction loan facility to a permanent loan that amortizes over a five-year period and matures in August 2019. The amended and restated permanent loan is represented by a $12.7 million promissory note that requires monthly principal payments of $70,778 plus monthly interest and a balloon payment of $8.5 million due at maturity. The amended and restated permanent loan is guaranteed by AAC, BHR and Messrs. Cartwright and Menz.

The Academy Real Estate, LLC

In May 2013, AAC, through The Academy Real Estate, LLC (“Academy Real Estate”), acquired a property located in Riverview, Florida for a purchase price of $5.8 million. AAC was renovating this property and planned to convert it into a treatment facility. AAC funded the purchase price with $1.6 million from cash on hand and $3.6 million in proceeds from a new bank loan with an existing lender. In addition, a $0.6 million deposit was paid on behalf of AAC by Greenhouse Real Estate in March 2013 and was reimbursed to Greenhouse Real Estate by AAC in the third quarter of 2013. AAC spent $0.6 million on renovations from May 2013 through December 9, 2013 and capitalized $72,000 of interest related to this construction.

On December 10, 2013, AAC sold its membership interests in Academy Real Estate to BHR for $3.1 million plus the assumption of outstanding debt totaling $3.6 million, with AAC and Messrs. Cartwright and Menz remaining as guarantors on the debt. AAC received $0.8 million in cash and a promissory note receivable totaling $2.3 million for the sale to BHR. At the time of this transaction, BHR was controlled by Messrs. Cartwright, Menz and Manz. The principal balance of the third party bank loan at June 30, 2014 remained at $3.6 million.

Other BHR Transactions

In November 2013, AAC entered into purchase agreements to acquire two outpatient centers: one in Arlington, Texas and the other in Las Vegas, Nevada. The purchase price for the Arlington facility is $0.8 million and the purchase price for the Las Vegas facility is $2.0 million. The purchase agreement for the Arlington facility was assigned to a subsidiary of BHR in December 2013, and the purchase agreement for the Las Vegas facility was assigned to a subsidiary of BHR in January 2014. For additional information related to these transactions, see Note 16 to our audited financial statements included elsewhere in this prospectus.

For additional information related to the BHR debt described above, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Financing Relationships” and Note 5 to our audited financial statements included elsewhere in this prospectus.

We have entered into various operating leases with BHR and its predecessor entities. BHR was formerly controlled by Messrs. Cartwright, Menz and Manz. These operating leases expire in October 2018. Commercial properties under the operating leases primarily include space required to perform client services and space for administrative facilities. Total rental payments to BHR and its predecessor entities were $3.9 million, $1.4 million and $0.3 million for 2013, 2012 and 2011, respectively.

 

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Other Relationships and Transactions

CRMS Relationship

In 2012, AAC began to transition its outsourced medical billing and collection process from third-party service providers to CRMS. Prior to the Reorganization Transactions discussed above, CRMS was owned 50% by the spouse of our Chief Executive Officer and 50% by the spouse of our President. During 2013 and 2012, AAC paid $2.8 million and $0.6 million in fees to CRMS, respectively. In addition, AAC leased office space and furniture to CRMS under a month to month arrangement in 2013, and total rental income recognized in 2013 was $0.1 million. In connection with the Reorganization Transactions, we acquired 100% of the outstanding membership interests in CRMS, and therefore, CRMS is now a wholly owned subsidiary of Holdings. See “Reorganization Transactions” above.

TSN Acquisition

The following transactions occurred in connection with the TSN Acquisition:

 

    AAC issued to James D. Bevell, our former Chief Innovation Officer, a subordinated note (the “Bevell Note”) in the principal amount of $3.2 million, payable in two tranches: (i) $1.1 million accrues interest at 5.0% annually and is payable in equal installments of $33,400 per month through September 2015 and (ii) $2.1 million accrues interest at 3.125% annually and is payable in one balloon payment due on August 31, 2015. In addition, we issued 888,868 shares of common stock (662,452 unrestricted shares and 226,416 restricted shares at a fair value of $6.27 per share). The purchase agreement executed in connection with the TSN Acquisition includes provisions that contemplate a potential purchase price adjustment at the maturity of the balloon payment to withhold up to $0.9 million in cash and cause the forfeiture of the 226,416 restricted shares of common stock if certain operational performance metrics are not achieved during the three year term of the Bevell Note. As of June 30, 2014, the outstanding principal amount of the Bevell Note was $2.0 million. The amounts of principal and interest paid from August 2012 to June 30, 2014 with respect to the Bevell Note were $632,060 and $69,708, respectively. In April 2013, AAC redeemed 444,434 shares of common stock from Mr. Bevell, which were issued to Mr. Bevell in connection with the TSN Acquisition, at $8.23 per share, for an aggregate purchase price of $3.7 million.

 

    AAC issued to Michael Blackburn, Vice President of Business Development of AAC, two separate subordinated notes. The first note was issued in the principal amount of $0.6 million and accrued interest at 3.125% annually. This note was paid in full in March 2013. The second note was issued in the principal amount of $3.1 million payable in two tranches: (i) $1.1 million accrues interest at 5.0% annually and is payable in equal installments of $33,400 per month through September 2015 and (ii) $2.0 million accrues interest at 3.125% annually and is payable in one balloon payment due on August 31, 2015. The purchase agreement executed in connection with the TSN Acquisition includes provisions that contemplate a potential purchase price adjustment at the maturity of the balloon payment to withhold up to $0.6 million in cash if certain operational performance metrics are not achieved during the three year term of the subordinated note. In March 2013, Mr. Blackburn converted $0.5 million of the 3.125% tranche of the note into shares of AAC common stock at a conversion price per share of $8.23. In connection with this conversion, AAC issued to Mr. Blackburn an amended and restated subordinated promissory note in the principal amount of $2.4 million payable in two tranches: (i) $0.9 million accrues interest at 5% annually and is payable in equal installments of $33,418 per month through September 2015 and (ii) $1.5 million accrues interest at 3.125% annually and is payable in one balloon payment due on August 31, 2015. As of June 30, 2014, the outstanding principal amount of the amended and restated note was $2.0 million. The aggregate amounts of principal and interest paid from August 2012 to June 30, 2014 with respect to these subordinated notes were $632,060 and $69,708, respectively.

 

   

AAC entered into a License Agreement, dated August 31, 2012, with AJG Solutions, Inc., an entity principally owned by Mr. Bevell. Under the License Agreement, AJG Solutions, Inc. granted to us a

 

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royalty-free license to use certain trademarks and certain other intangible assets related to the operations we acquired in the TSN Acquisition. The license has a three year term, at the end of which period the licensed assets will be assigned to us, subject to the satisfaction of certain conditions.

 

    AAC entered into an Agreement Among Stockholders with Messrs. Cartwright, Menz and Bevell, dated August 31, 2012. Under the agreement, each of Messrs. Cartwright and Menz agreed to cause AAC to offer Mr. Bevell certain rights to participate, on a proportionate basis, in any purchase of securities from AAC by either of Mr. Cartwright or Mr. Menz. In addition, AAC agreed that it would not include any equity securities owned by Mr. Cartwright or Mr. Menz in a registration statement filed with the SEC unless it granted Mr. Bevell the right to participate in such a registration statement on a proportionate basis. Mr. Bevell also has certain co-sale and tag-along rights under the agreement. Except for the provision granting registration rights to Mr. Bevell, which such rights will continue following this offering, this agreement will terminate in connection with this offering.

Vaco Relationship

We are party to certain placement agreements with Vaco Nashville, LLC, an entity substantially owned by Vaco Holdings, LLC. Jerry D. Bostelman, one of our directors, is an executive officer and significant owner of Vaco Holdings, LLC. Vaco Nashville, LLC has provided us accounting professionals to bolster our accounting department and is typically paid 25% of each employee’s first year salary as a placement fee or paid an hourly rate for temporary professional services. We paid aggregate fees to Vaco Nashville, LLC of $67,300 in 2011, $103,750 in 2012 and $116,898 in 2013 and $212,611 for the six months ended June 30, 2014.

Employment

Michael Stetar, who serves as our Chief Technology Officer, was hired in December 2010. Mr. Stetar is the brother-in-law of our President. AAC paid Mr. Stetar $60,000, $127,250 and $184,218 in total compensation in 2011, 2012 and 2013, respectively, and $99,000 for the six months ended June 30, 2014.

Professional Groups

During 2013, AAC was affiliated with the Professional Groups located in each of the five states in which we operate. These Professional Groups engage physicians and mid-level service providers and provide professional services to our clients through professional services agreements with each treatment facility. Under the professional services agreements, the Professional Groups also provide a physician to serve as medical director for the applicable facility. The Professional Groups either bill the payor for their services directly or are compensated by the treatment facility based on fair market value hourly rates. Each of the professional services agreements has a term of five years and will automatically renew for additional one year periods. For additional information related to the Professional Groups, see Note 5 to our audited financial statements included elsewhere in this prospectus. We provided the initial working capital funding in connection with the formation of the Professional Groups in return for a receivable. We make additional advances to the Professional Groups during periods in which there is a shortfall between revenues collected by the Professional Group from the treatment facilities and payors, on the one hand, and the Professional Group’s contracting expenses and payroll requirements, on the other hand, thereby increasing the balance of the amounts owed us. Excess cash flow of the Professional Groups is repaid to us, resulting in a decrease in the receivable. The Professional Groups are obligated to repay these funds and are charged commercially reasonable interest. We had a receivable from each of the Professional Groups at June 30, 2014. Total advances to the Professional Groups at June 30, 2014 were $1.9 million. The receivables due to us from each of the Professional Groups are eliminated in the consolidation of the Professional Groups as VIEs.

As of June 30, 2014, three of the five Professional Groups were owned by Mr. Cartwright, our CEO. In August 2014, Mr. Cartwright’s ownership interest in the Professional Groups was transferred to licensed physicians of the Professional Groups. The Professional Groups made no payments to AAC in 2013 or the first half of 2014. Mr. Cartwright did not receive any separate compensation or financial interest in connection with his ownership in these entities.

 

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Procedure for Approval of Transactions with Related Parties

Our articles of incorporation and our amended and restated bylaws, which we refer to as our bylaws, which will become effective upon the closing of this offering, do not restrict any of our directors, officers, stockholders or affiliates from having a pecuniary interest in an investment or transaction that we have an interest in or from conducting, for their own account, business activities of the type we conduct. However, our Board of Directors recognizes that transactions or relationships between us and our subsidiaries and our directors, executive officers, immediate family members of our executive officers and directors and greater than 5% beneficial owners of our common stock may present a heightened risk of conflicts of interest or the perception thereof. As a result, the Board of Directors has adopted a written Related Party Transaction Policy (the “Policy”) to ensure that all related party transactions shall be subject to approval or ratification in accordance with the procedures set forth in the Policy.

Prior to the entry of any potential related party transaction, such transaction, arrangement or relationship, together with a summary of all material information concerning such transaction, arrangement or relationship, shall be reported to the General Counsel for evaluation . If the General Counsel determines that the transaction is a related party transaction and is not subject to the exceptions described in the Policy, the General Counsel will submit the transaction to the Audit Committee for consideration. In the event our Chief Executive Officer, President, Chief Financial Officer, Chief Operating Officer, General Counsel or Chief Accounting Officer becomes aware of a related party transaction that has not been previously approved or ratified, the transaction will promptly be submitted to the Audit Committee or its chair, which will evaluate all available options, including ratification, amendment or termination of the transaction. In determining whether to approve or ratify a related party transaction, the Audit Committee will take into account, among other factors it deems appropriate, whether the related party transaction is on terms no less favorable than terms generally available to an unaffiliated third party under the same or similar circumstances and the extent of the related party’s interest in the transaction. The Audit Committee will annually review each new or continuing related party transaction to determine if we should enter into or continue such related party transaction. Despite the existence and application of the Policy, we cannot assure you that the Policy or provisions of law will always be successful in eliminating the influence of conflicts of interest (whether actual or perceived), and if they are not successful, decisions could be made that might fail to reflect fully the interests of all stockholders.

 

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PRINCIPAL STOCKHOLDERS

The following table sets forth information regarding beneficial ownership of our capital stock outstanding as of August 14, 2014 by:

 

    each person, or group of affiliated persons, known by us to beneficially own more than 5% of our common stock;

 

    each of our directors;

 

    each of our named executive officers; and

 

    all of our directors and executive officers as a group.

The number of shares and percentage of shares beneficially owned before this offering shown in the table is based upon 9,975,885 shares of common stock issued and outstanding as of August 14, 2014. The number of shares and percentage of shares beneficially owned after this offering also gives effect to the issuance by us of shares of common stock in this offering. The percentage ownership information assumes no exercise of the underwriters’ over-allotment option.

Each individual or entity shown in the table has furnished information with respect to beneficial ownership. We have determined beneficial ownership in accordance with the SEC’s rules. These rules generally attribute beneficial ownership of securities to persons who possess sole or shared voting power or investment power with respect to those securities. In addition, the rules include shares of common stock issuable pursuant to the exercise of stock options, warrants, or other rights that are either immediately exercisable or exercisable within 60 days of June 30, 2014. These shares are deemed to be outstanding and beneficially owned by the person holding those options, warrants or other rights for the purpose of computing the percentage ownership of that person, but they are not treated as outstanding for the purpose of computing the percentage ownership of any other person. Unless otherwise indicated, the persons or entities identified in this table have sole voting and investment power with respect to all shares shown as beneficially owned by them, subject to applicable community property laws.

Except as otherwise noted below, the address for each person or entity listed in the table is c/o AAC Holdings, Inc., 115 East Park Drive, Second Floor, Brentwood, Tennessee 37027.

 

            Percentage of Shares Outstanding (1)  

Beneficial Owner

   Number of Shares
Beneficially
Owned (1)
     Before
Offering
    After
Offering
    After
Offering as
Adjusted (2)
 

Directors and Named Executive Officers

         

Michael T. Cartwright (3)

     3,805,062         38.1                                  

Jerrod N. Menz (4)

     3,451,565         34.6                                  

Candance A. Henderson-Grice (5)

     53,363         *                                     

Lucius E. Burch, III

     624,381         6.3                                  

Jerry D. Bostelman

     374,969         3.8                                  

David C. Kloeppel (6)

     125,220         1.3                                  

Darrell S. Freeman, Sr. (7)

     99,731         1.0                                  

Richard E. Ragsdale (8)

     34,090         *                                     

All executive officers and directors as a group (11 persons)

     9,003,558         90.3                                  

 

 

  * Represents beneficial ownership of less than 1% of our outstanding common stock.
  (1)

Under Rule 13d-3, a beneficial owner of a security includes any person who, directly or indirectly, through any contract, arrangement, understanding, relationship, or otherwise has or shares: (i) voting power, which includes the power to vote or to direct the voting of shares; and (ii) investment power,

 

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  which includes the power to dispose or direct the disposition of shares. Certain shares may be deemed to be beneficially owned by more than one person (if, for example, persons share the power to vote or the power to dispose of the shares). In addition, shares are deemed to be beneficially owned by a person if the person has the right to acquire the shares (for example, upon exercise of an option) within 60 days of the date as of which the information is provided. In computing the percentage ownership of any person, the amount of shares outstanding is deemed to include the amount of shares beneficially owned by such person (and only such person) by reason of these acquisition rights. Based upon information furnished to us by the directors and executive officers or obtained from our stock transfer books showing 9,975,885 shares of common stock issued and outstanding as of August 14, 2014.
  (2) Ownership percentages presented in this column are adjusted to reflect the subsidiary short-form merger with AAC that we plan to consummate following this offering, whereby the legacy holders of the common stock of AAC, which holders did not participate in the Private Share Exchange, will be entitled to receive Holdings shares on a one-for-one basis.
  (3) Consists of (i) 2,515,424 shares of record held by Mr. Cartwright, (ii) 607,533 shares held of record by the Irrevocable Family Trust of Tina Cartwright of which Mr. Cartwright serves as one of two trustees, (iii) 607,533 shares held of record by the Irrevocable Family Trust of Michael T. Cartwright of which Mr. Cartwright’s family is the beneficiary and (iv) 74,572 shares held of record by Tina F. Cartwright, Mr. Cartwright’s spouse, of which Mr. Cartwright has shared voting and investment power.
  (4) Consists of (i) 2,161,927 shares of record held by Mr. Menz, (ii) 607,533 shares held of record by the Irrevocable Family Trust of Victoria Menz, of which Mr. Menz serves as one of two trustees, (iii) 607,533 shares held of record by the Irrevocable Family Trust of Jerrod Menz of which Mr. Menz’s family is the beneficiary and (iv) 74,572 shares held of record by Victoria Menz, Mr. Menz’s spouse. Mr. Menz has shared voting and investment power over the shares held by the Victoria Menz Trust.
  (5) Includes 3,918 shares held of record by a retirement account controlled by Alan Grice, Ms. Henderson-Grice’s spouse.
  (6) Includes 121,507 shares held of record by David and Ann Kloeppel, as Tenants in Common. Mr. Kloeppel has shared voting power and shared investment power over these shares.
  (7) Includes (i) 60,753 shares held of record by Zycron, Inc., of which Mr. Freeman is the Executive Chairman and (ii) 15,673 shares held of record by Milan Investment Group, LLC, which is controlled by Gloria J. Freeman, Mr. Freeman’s spouse.
  (8) Consists of 34,090 shares held of record by the Richard Elliot Ragsdale Revocable Trust, of which Mr. Ragsdale serves as the trustee and is a beneficiary.

 

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DESCRIPTION OF CAPITAL STOCK

Our authorized capital stock consists of 70,000,000 shares of common stock, par value $0.001 per share, and 5,000,000 shares of preferred stock, par value $0.001 per share.

As of August 14, 2014, we had 9,975,885 shares of our common stock issued and outstanding, held by 66 stockholders of record. We have no preferred stock outstanding.

Based on the number of shares of common stock outstanding as of            , 2014, and assuming the issuance by us of            shares of common stock in this offering, there will be            shares of common stock outstanding upon completion of this offering.

The following description of our capital stock and provisions of our articles of incorporation and our amended and restated bylaws, which we refer to as our bylaws, are summaries and are qualified by reference to the articles of incorporation and to the bylaws that will be in effect upon the closing of this offering. Copies of these documents have been filed with the SEC as exhibits to our registration statement, of which this prospectus forms a part.

Governing Law and Organization Documents

Stockholders’ rights and related matters are governed by the laws of the State of Nevada, our articles of incorporation and our bylaws. Our articles of incorporation may not be amended without the affirmative vote of at least a majority of the shares of our then outstanding common stock. Our bylaws may be amended by either the affirmative vote of a majority of all shares outstanding and entitled to vote generally in the election of directors or by an affirmative vote of a majority of our directors then holding office.

Common Stock

Voting Rights . Each holder of common stock is entitled to one vote for each share of common stock on all matters submitted to a vote of the stockholders, including the election of directors. Our articles of incorporation and bylaws do not provide for cumulative voting rights. Because of this, the holders of a majority of the shares of common stock entitled to vote in any election of directors can elect all of the directors standing for election, if they should so choose.

Dividends . Subject to preferences that may be applicable to any then outstanding preferred stock, the holders of common stock are entitled to receive dividends, if any, as may be declared from time to time by our Board of Directors out of legally available funds.

Liquidation . In the event of our liquidation, dissolution or winding up, holders of common stock will be entitled to share ratably in the net assets legally available for distribution to stockholders after the payment of all of our debts and other liabilities and obligations, subject to the satisfaction of any liquidation preference granted to the holders of any outstanding shares of preferred stock.

Rights and Preferences . Upon effectiveness of this registration statement, holders of common stock will have no preemptive, conversion or subscription rights, and there are no redemption or sinking fund provisions applicable to the common stock. The rights, preferences and privileges of the holders of common stock are subject to, and may be adversely affected by, the rights of the holders of shares of any series of preferred stock that our Board of Directors may designate and issue in the future.

Preferred Stock

Our Board of Directors has the authority, without further action by the stockholders, to issue up to 5,000,000 shares of preferred stock in one or more series, to establish from time to time the number of shares to

 

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be included in each such series, to fix the rights, preferences, privileges and restrictions of the shares of each wholly unissued series, including dividend rights, conversion rights, voting rights, terms of redemption, liquidation preference and sinking fund terms, and to increase or decrease the number of shares of any such series (but not below the number of shares of such series then outstanding).

Our Board of Directors may authorize the issuance of preferred stock with voting or conversion rights that could have the effect of restricting dividends on our common stock, diluting the voting power of our common stock, impairing the liquidation rights of our common stock or otherwise adversely affect the rights of holders of our common stock. The issuance of preferred stock, while providing flexibility in connection with possible acquisitions and other corporate purposes, could, among other things, have the effect of delaying, deferring or preventing a change of control and may adversely affect the market price of the common stock. Upon the closing of this offering, no shares of preferred stock will be outstanding, and we have no current plans to issue any shares of preferred stock.

Nevada Anti-Takeover Law and Provisions of Our Articles of Incorporation and Bylaws

Our articles of incorporation and our bylaws contain certain provisions that could have the effect of delaying, deterring or preventing another party from acquiring control of us, and therefore could adversely affect the market price of our common stock. These provisions may also discourage coercive takeover practices and inadequate takeover bids, and are designed, in part, to encourage persons seeking to acquire control of us to negotiate first with our Board of Directors. We believe that the benefits of increased protection of our potential ability to negotiate more favorable terms with an unfriendly or unsolicited acquirer outweigh the disadvantages of potentially discouraging a proposal to acquire us.

Among other things, our articles of incorporation and bylaws:

 

    permit our Board of Directors to issue up to 5,000,000 shares of preferred stock, with any rights, preferences and privileges as they may designate (including the right to approve an acquisition or other change of control);

 

    provide that the authorized number of directors may be changed only by resolution of our Board of Directors;

 

    provide that all vacancies, including newly created directorships, may, except as otherwise required by law, be filled by the affirmative vote of a majority of directors then in office, even if less than a quorum;

 

    provide that stockholders seeking to present proposals at a meeting of stockholders or to nominate candidates for election as directors at a meeting of stockholders must provide advance notice in writing, and also specify requirements as to the form and content of a stockholder’s notice;

 

    provide that our stockholders may not take action by written consent, but may only take action at annual or special meetings of our stockholders;

 

    do not provide for cumulative voting rights (therefore allowing the holders of a majority of the shares of common stock entitled to vote in any election of directors to elect all of the directors standing for election); and

 

    provide that special meetings of our stockholders may be called only by the chairman of the Board of Directors, our Chief Executive Officer, the Board of Directors pursuant to a resolution adopted by a majority of the total number of authorized directors or the holders of a majority of the outstanding shares of voting stock.

The amendment of any of these provisions would require the approval by the holders of at least a majority of the shares of our then outstanding common stock for amendments to our articles of incorporation and the approval by holders of a majority of the shares of our then outstanding common stock and entitled to vote generally in the election of directors for amendments to our bylaws.

 

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The provisions of our articles of incorporation and bylaws could have the effect of discouraging others from attempting hostile takeovers and, as a consequence, they might also inhibit temporary fluctuations in the market price of our common stock that often result from actual or rumored hostile takeover attempts. These provisions might also have the effect of preventing changes in our management. It is possible that these provisions could make it more difficult to accomplish transactions that stockholders might otherwise deem to be in their best interests.

Listing on the New York Stock Exchange

Our common stock has been approved for listing on the NYSE under the symbol “AAC”.

Transfer Agent and Registrar

The transfer agent and registrar for our common stock is American Stock Transfer and Trust Company, LLC.

 

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SHARES ELIGIBLE FOR FUTURE SALE

Immediately prior to this offering, there has been no public market for our common stock. Future sales of substantial amounts of common stock in the public market could adversely affect prevailing market prices. Furthermore, because only a limited number of shares will be available for sale shortly after this offering because of contractual and legal restrictions on resale described below, sales of substantial amounts of common stock in the public market after the restrictions lapse could adversely affect the prevailing market price for our common stock as well as our ability to raise equity capital in the future.

Based on the number of shares of common stock outstanding as of                , 2014, upon the closing of this offering, shares of common stock will be outstanding, assuming no exercise of the underwriters’ over-allotment option. All of the shares sold in this offering will be freely tradeable unless held by an affiliate of ours. Except as set forth below, the remaining            shares of common stock outstanding after this offering will be restricted as a result of securities laws or lock-up agreements. These remaining shares will generally become available for sale in the public market as follows:

 

    no restricted shares will be eligible for immediate sale upon the closing of this offering;

 

    9,975,885 restricted shares will be eligible for sale under Rule 144 or Rule 701 upon expiration of lock-up agreements beginning 181 days after the date of this offering; and

 

    630,886 shares of our outstanding common stock will be freely tradeable immediately after the effectiveness of a subsequent Form S-4 registration statement to register the shares to be issued pursuant to our short-form merger with AAC following the completion of this offering.

Rule 144

In general, under Rule 144 as currently in effect, beginning 90 days after the effective date of the registration statement of which this prospectus is a part, any person who is not an affiliate of ours and who has held their shares for at least six months, including the holding period of any prior owner other than one of our affiliates, may sell shares without restriction, provided current public information about us is available. In addition, under Rule 144, any person who is not an affiliate of ours and has held their shares for at least one year, including the holding period of any prior owner other than one of our affiliates, would be entitled to sell an unlimited number of shares immediately upon the closing of this offering without regard to whether current public information about us is available. Beginning 90 days after the effective date of the registration statement of which this prospectus is a part, a person who is an affiliate of ours and who has beneficially owned restricted securities for at least six months, including the holding period of any prior owner other than one of our affiliates, is entitled to sell a number of restricted shares within any three-month period that does not exceed the greater of:

 

    1% of the number of shares of our common stock then outstanding, which will equal approximately             shares immediately after this offering; or

 

    the average weekly trading volume of our common stock on the NYSE during the four calendar weeks preceding the filing of a notice on Form 144 with respect to the sale.

Sales of restricted shares under Rule 144 held by our affiliates or persons selling shares on behalf of our affiliates are also subject to requirements regarding the manner of sale, notice and the availability of current public information about us. Rule 144 also provides that affiliates relying on Rule 144 to sell shares of our common stock that are not restricted shares must nonetheless comply with the same restrictions applicable to restricted shares, other than the holding period requirement.

Notwithstanding the availability of Rule 144, the holders of all of our restricted shares have entered into lock-up agreements as described below and their restricted shares will not become eligible for sale until the expiration of the restrictions set forth in those agreements.

 

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Rule 701

Under Rule 701, shares of our common stock acquired upon the issuance and exercise of options or pursuant to other rights granted under our equity incentive plans may be resold, by:

 

    persons other than affiliates, beginning 90 days after the effective date of the registration statement of which this prospectus is a part, subject only to the manner-of-sale provisions of Rule 144; and

 

    our affiliates, beginning 90 days after the effective date of the registration statement of which this prospectus is a part, subject to the manner-of-sale and volume limitations, current public information and filing requirements of Rule 144, in each case, without compliance with the six-month holding period requirement of Rule 144.

As of June 30, 2014, there were no outstanding options to purchase shares of our common stock.

Lock-up Agreements

We, each of our directors, executive officers and stockholders have agreed, and each of the purchasers in the directed share program will agree, without the prior written consent of William Blair & Company, L.L.C. and Wells Fargo Securities, LLC, and subject to certain exceptions, not to, directly or indirectly, offer, sell, issue (in the case of us), contract to sell, pledge or, among other things, dispose of, directly or indirectly, any shares of common stock, options or warrants to purchase any shares of common stock or any securities that are convertible into or exchangeable for, or that represent the right to receive, common stock, held of record or beneficially owned, for a period of 180 days after the date of this prospectus. See “Underwriting” for a description of these lock-up agreements.

Equity Incentive Plans

We intend to file a registration statement on Form S-8 under the Securities Act after the closing of this offering to register the 1,000,000 shares reserved for issuance under our 2014 Equity Incentive Plan. The registration statement is expected to be filed and become effective as soon as practicable after the closing of this offering. Accordingly, shares registered under the registration statement will be available for sale in the open market following its effective date, subject to vesting of such shares, Rule 144 volume limitations and the lock-up agreements described above, if applicable.

Short-Form Merger

We intend to file a Form S-4 registration statement with the SEC to register the 630,886 shares that will be issued pursuant to our short-form merger with AAC following the completion of this offering, whereby the legacy holders who did not participate in the Private Share Exchange would be entitled to receive Holdings shares on a one-for-one basis. When the registration statement is declared effective by the SEC, and, subject to applicable lock-up agreements, if any, these shares may be resold without restriction in the public marketplace.

 

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MATERIAL U.S. FEDERAL INCOME TAX CONSEQUENCES TO NON-U.S. HOLDERS

The following summary describes the material U.S. federal income tax consequences of the acquisition, ownership and disposition of our common stock acquired in this offering by Non-U.S. Holders (as defined below). This discussion does not address all aspects of U.S. federal income taxes and does not deal with state, local or non-U.S. tax consequences that may be relevant to Non-U.S. Holders in light of their particular circumstances, nor does it address U.S. federal tax consequences other than income taxes. Special rules different from those described below may apply to certain Non-U.S. Holders that are subject to special treatment under the Internal Revenue Code of 1986, as amended, or the Code, such as banks, thrifts, financial institutions, insurance companies, tax-exempt organizations, broker-dealers and traders in securities, U.S. expatriates, “controlled foreign corporations,” “passive foreign investment companies,” corporations that accumulate earnings to avoid U.S. federal income tax, persons that hold our common stock as part of a “straddle,” “hedge,” “conversion transaction,” “synthetic security” or integrated investment or other risk reduction strategy, tax-qualified retirement plans, persons deemed to sell our common stock under the constructive sale provisions of the Code, persons subject to the alternative minimum tax, persons that own, or are deemed to own, more than 5% of our outstanding common stock (except to the extent specifically set forth below), partnerships and other pass-through entities, and investors or partners in such pass-through entities or an entity that is treated as a disregarded entity for U.S. federal income tax purposes (regardless of its place of organization or formation). Such Non-U.S. Holders are urged to consult their own tax advisors to determine the U.S. federal, state, local and other tax consequences that may be relevant to them. Furthermore, the discussion below is based upon the provisions of the Code, the Treasury regulations promulgated thereunder, rulings and judicial decisions thereunder as of the date hereof, and such authorities may be repealed, revoked or modified, perhaps retroactively, so as to result in U.S. federal income tax consequences different from those discussed below. We have not requested a ruling from the Internal Revenue Service, or the IRS, with respect to the statements made and the conclusions reached in the following summary, and there can be no assurance that the IRS or a court will agree with such statements and conclusions. This discussion assumes that the Non-U.S. Holder holds our common stock as a “capital asset” within the meaning of Section 1221 of the Code (generally, property held for investment).

The following discussion is for general information only and is not tax advice. Persons considering the purchase of our common stock pursuant to this offering should consult their own tax advisors concerning the U.S. federal income tax consequences of acquiring, owning and disposing of our common stock in light of their particular situations as well as any consequences arising under the laws of any other taxing jurisdiction, including any state, local or non-U.S. tax consequences or any U.S. federal non-income tax consequences.

For the purposes of this discussion, a “Non-U.S. Holder” is, for U.S. federal income tax purposes, a beneficial owner of our common stock that is not a U.S. Holder. A “U.S. Holder” means a beneficial owner of our common stock that is for U.S. federal income tax purposes (a) an individual who is a citizen or resident of the United States, (b) a corporation (or any other entity treated as a corporation for U.S. federal income tax purposes) created or organized in or under the laws of the United States, any state thereof or the District of Columbia, (c) an estate the income of which is subject to U.S. federal income taxation regardless of its source or (d) a trust if it (1) is subject to the primary supervision of a court within the United States and one or more U.S. persons have the authority to control all substantial decisions of the trust or (2) has a valid election in effect under applicable Treasury regulations to be treated as a U.S. person. Also, partnerships, or other entities that are treated as partnerships for U.S. federal income tax purposes (regardless of their place of organization or formation) and partners in such partnerships or other entities and entities that are treated as disregarded entities for U.S. federal income tax purposes (regardless of their place of organization or formation) are not addressed by this discussion and are, therefore, not considered to be Non-U.S. Holders for the purposes of this discussion.

Distributions

Subject to the discussion below, distributions, if any, made on our common stock to a Non-U.S. Holder to the extent made out of our current or accumulated earnings and profits (as determined under U.S. federal

 

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income tax principles) generally will constitute dividends for U.S. tax purposes and will be subject to withholding tax at a rate of 30% of the gross amount of the dividends or such lower rate as may be specified by an applicable income tax treaty. To obtain a reduced rate of withholding under a treaty, a Non-U.S. Holder generally will be required to provide us or our paying agent with a properly executed IRS Form W-8BEN (or applicable successor form), or other appropriate form, certifying the Non-U.S. Holder’s entitlement to benefits under that treaty. If a Non-U.S. Holder holds stock through a financial institution or other agent acting on the holder’s behalf, the Non-U.S. Holder will be required to provide appropriate documentation to such agent. The Non-U.S. Holder’s agent will then be required to provide certification to us or our paying agent, either directly or through other intermediaries. This certification must be provided to us or the relevant paying agent prior to the payment of dividends and must be updated periodically. If you do not provide the relevant paying agent with the required certification but are eligible for a reduced rate of U.S. federal withholding tax under an income tax treaty, you should consult with your own tax advisor to determine if you are able to obtain a refund or credit of any excess amounts withheld by timely filing an appropriate claim for a refund with the IRS.

We generally are not required to withhold tax on dividends paid to a Non-U.S. Holder that are effectively connected with the Non-U.S. Holder’s conduct of a trade or business within the United States (and, if required by an applicable income tax treaty, are attributable to a permanent establishment that such Non-U.S. Holder maintains in the United States) if a properly executed IRS Form W-8ECI (or applicable successor form), stating that the dividends are so connected, is furnished to us or our paying agent (or, if stock is held through a financial institution or other agent, to such agent). In general, such effectively connected dividends will be subject to U.S. federal income tax, on a net income basis at the regular graduated U.S. federal income tax rates, unless a specific treaty exemption applies. A corporate Non-U.S. Holder receiving effectively connected dividends may also be subject to an additional “branch profits tax,” which is imposed, under certain circumstances, at a rate of 30% (or such lower rate as may be specified by an applicable treaty) on the corporate Non-U.S. Holder’s effectively connected earnings and profits, subject to certain adjustments. Non-U.S. Holders are urged to consult any applicable income tax treaties that may provide for different rules.

To the extent distributions on our common stock, if any, exceed our current and accumulated earnings and profits, they will first be treated as a non-taxable return of capital reducing your tax basis in our common stock, but not below zero, and thereafter will be treated as gain from the sale of stock, the treatment of which is discussed in the next section.

Gain On Disposition of Our Common Stock

Subject to the discussion below under “Recently Enacted Legislation Affecting Taxation of Our Common Stock Held By Or Through Non-U.S. Entities,” a Non-U.S. Holder generally will not be subject to U.S. federal income tax with respect to gain realized on a sale or other disposition of our common stock unless (a) the gain is effectively connected with the conduct of a trade or business of such Non-U.S. Holder in the United States (and, if required by an applicable income tax treaty, is attributable to a permanent establishment that such Non-U.S. Holder maintains in the United States), (b) the Non-U.S. Holder is a nonresident alien individual and is present in the United States for 183 or more days in the taxable year of the disposition and certain other conditions are met, or (c) our common stock constitutes a “United States real property interest” by reason of our status as a “United States real property holding corporation” within the meaning of Code Section 897(c)(2) at any time within the shorter of the five-year period preceding such disposition or such Non-U.S. Holder’s holding period.

If you are a Non-U.S. Holder described in (a) above, you will be required to pay tax on the net gain derived from the sale at regular graduated U.S. federal income tax rates, unless a specific treaty exemption applies, and corporate Non-U.S. Holders described in (a) above may be subject to the additional branch profits tax at a 30% rate (or such lower rate as may be specified by an applicable income tax treaty) on their effectively connected earnings and profits, subject to certain adjustments.

 

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If you are an individual Non-U.S. Holder described in (b) above, you will be required to pay a flat 30% tax (or such lower rate specified by an applicable income tax treaty) on the gain derived from the sale, which gain may be offset by U.S. source capital losses (even though you are not considered a resident of the United States).

With respect to (c) above, in general, we would be a United States real property holding corporation if interests in U.S. real estate comprised (by fair market value) at least half of our assets. We believe that we are not, and do not anticipate becoming, a United States real property holding corporation; however, there can be no assurance that we will not become a U.S. real property holding corporation in the future. Even if we are treated as a U.S. real property holding corporation, gain realized by a Non-U.S. Holder on a disposition of our common stock will not be subject to U.S. federal income tax so long as (1) the Non-U.S. Holder owned, directly, indirectly and constructively, no more than 5% of our common stock at all times within the shorter of (i) the five-year period preceding the disposition or (ii) the holder’s holding period and (2) our common stock is “regularly traded,” as defined in applicable Treasury regulations, on an established securities market. We expect our common stock to be “regularly traded” on an established securities market, but there can be no assurance that our common stock will be so traded in the future. If gain on the sale or other taxable disposition of our stock were subject to taxation as described in (c) above, the Non-U.S. Holder would be subject to regular U.S. federal income tax with respect to such gain in generally the same manner as a U.S. person.

Information Reporting Requirements and Backup Withholding

Generally, we or certain financial middlemen must report information to the IRS with respect to any dividends we pay on our common stock, including the amount of any such dividends, the name and address of the recipient, and the amount, if any, of tax withheld. A similar report is sent to the Non-U.S. Holder to whom any such dividends are paid. These information reporting requirements apply even if no withholding was required because the distributions were effectively connected with the Non-U.S. Holder’s conduct of a United States trade or business, or withholding was reduced or eliminated by an applicable income tax treaty. Pursuant to tax treaties or certain other agreements, the IRS may make its reports available to tax authorities in the recipient’s country of residence.

Dividends paid by us (or our paying agents) to a Non-U.S. Holder may also be subject to U.S. backup withholding. U.S. backup withholding generally will not apply to a Non-U.S. Holder who provides a properly executed IRS Form W-8BEN or IRS Form W-8ECI or otherwise establishes an exemption. Notwithstanding the foregoing, backup withholding may apply if the relevant paying agent has actual knowledge, or reason to know, that the holder is a U.S. person who is not an exempt recipient. The current backup withholding rate is 28%.

Under current U.S. federal income tax law, U.S. information reporting and backup withholding requirements generally will apply to the proceeds of a disposition of our common stock effected by or through a U.S. office of any U.S. or non-U.S. broker, except that information reporting and backup withholding requirements may be avoided if the holder provides a properly executed IRS Form W-8BEN or otherwise meets documentary evidence requirements for establishing Non-U.S. Holder status or otherwise establishes an exemption. Except as described in the discussion of recently enacted legislation below, U.S. information reporting and backup withholding requirements will generally not apply to a payment of disposition proceeds to a Non-U.S. Holder where the transaction is effected outside the United States through a non-U.S. office of a non-U.S. broker. Information reporting and backup withholding requirements may, however, apply to a payment of disposition proceeds if the broker has actual knowledge, or reason to know, that the holder is, in fact, a U.S. person. For information reporting purposes, certain brokers with substantial U.S. ownership or operations will generally be treated in a manner similar to U.S. brokers.

Backup withholding is not an additional tax. If backup withholding is applied to you, you should consult with your own tax advisor to determine if you are able to obtain a tax refund or credit with respect to such backup withholding.

 

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Recently Enacted Legislation Affecting Taxation of Our Common Stock Held By Or Through Non-U.S. Entities

Recently enacted legislation may impose withholding taxes on certain types of payments made to “foreign financial institutions” (as specially defined under those rules) and certain other non-U.S. entities. Under this legislation, the failure to comply with additional certification, information reporting and other specified requirements could result in withholding tax being imposed on payments of dividends and sales proceeds to foreign intermediaries or certain Non-U.S. Holders.

The legislation imposes a 30% withholding tax on dividends on, and gross proceeds from the sale or other disposition of, our common stock paid to a foreign financial institution or to a foreign non-financial entity, unless (i) the foreign financial institution undertakes certain diligence and reporting obligations (ii) the foreign non-financial entity either certifies it does not have any substantial U.S. owners or furnishes identifying information regarding each substantial U.S. owner, or (iii) the foreign financial institution or foreign non-financial entity otherwise qualifies for an exemption from these rules. In addition, if the payee is a foreign financial institution and is subject to the diligence and reporting requirements in clause (i) above, it generally must enter into an agreement with the U.S. Treasury Department that requires, among other things, that it undertake to identify accounts held by certain U.S. persons or U.S.-owned foreign entities, annually report certain information about such accounts, and withhold 30% on payments to non-compliant foreign financial institutions and certain other account holders. Foreign financial institutions located in jurisdictions that have an intergovernmental agreement with the United States governing this legislation may be subject to different rules.

Under applicable Treasury regulations, any obligation to withhold under the new legislation with respect to dividends on our common stock will not begin until July 1, 2014, and with respect to gross proceeds on disposition of our common stock, will not begin until January 1, 2017. Because we may not know the extent to which a distribution is a dividend for U.S. federal income tax purposes as the time it is made, for purposes of these withholding rules, we may treat the entire distribution as a dividend.

Non-U.S. Holders of our common stock should consult their tax advisors regarding the effect, if any, of this legislation on their ownership and disposition of our common stock.

THE PRECEDING DISCUSSION OF MATERIAL U.S. FEDERAL INCOME TAX CONSIDERATIONS IS FOR GENERAL INFORMATION ONLY. IT IS NOT TAX ADVICE. EACH PROSPECTIVE INVESTOR SHOULD CONSULT ITS OWN TAX ADVISOR REGARDING THE TAX CONSEQUENCES OF PURCHASING, HOLDING AND DISPOSING OF OUR COMMON STOCK, INCLUDING THE CONSEQUENCES OF ANY PROPOSED CHANGE IN APPLICABLE LAW, AS WELL AS TAX CONSEQUENCES ARISING UNDER ANY STATE, LOCAL, NON-U.S. OR U.S. FEDERAL NON-INCOME TAX LAWS.

 

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UNDERWRITING

The underwriters named below have severally agreed, subject to the terms and conditions set forth in the underwriting agreement by and among us and William Blair & Company, L.L.C. and Wells Fargo Securities, LLC, as representatives of the underwriters, to purchase from us the respective number of shares of common stock set forth opposite each underwriter’s name in the table below. William Blair & Company, L.L.C. and Wells Fargo Securities, LLC are acting as joint-bookrunning managers, and Raymond James & Associates, Inc. and Avondale Partners, LLC are acting as co-managers for this offering.

 

Underwriter

   Number of
Shares

William Blair & Company, L.L.C.

  

Wells Fargo Securities, LLC

  

Raymond James & Associates, Inc.

  

Avondale Partners, LLC

  
  

 

Total

  
  

 

This offering will be underwritten on a firm commitment basis. In the underwriting agreement, the underwriters have agreed, subject to the terms and conditions set forth therein, to purchase the shares of our common stock being sold pursuant to this prospectus at a price per share equal to the public offering price less the underwriting discount specified on the cover of this prospectus. According to the terms of the underwriting agreement, the underwriters either will purchase all of the shares of our common stock being sold pursuant to this prospectus or none of them. In the event of default by any underwriter, in certain circumstances, the purchase commitments of the non-defaulting underwriters may be increased or the underwriting agreement may be terminated.

The representatives of the underwriters have advised us that the underwriters propose to offer our common stock to the public initially at the public offering price set forth on the cover of this prospectus and to selected dealers at such price less a concession of not more than $         per share. The underwriters may allow, and such dealers may re-allow, a concession not in excess of $         per share to certain other dealers. The underwriters will offer the shares of our common stock subject to prior sale and subject to receipt and acceptance of the shares by the underwriters. The underwriters may reject any order to purchase shares of our common stock in whole or in part. The underwriters expect that we will deliver the shares to the underwriters through the facilities of The Depository Trust Company in New York, New York on or about                     , 2014. At that time, the underwriters will pay us for the shares in immediately available funds. After commencement of the public offering, the representatives may change the public offering price and other selling terms.

We have granted the underwriters an option, exercisable within 30 days after the date of this prospectus, to purchase up to an aggregate of                additional shares of common stock at the same price per share to be paid by the underwriters for the other shares offered hereby solely for the purpose of covering over-allotments, if any. If the underwriters purchase any such additional shares pursuant to this option, each of the underwriters will be committed to purchase such additional shares in approximately the same proportion as set forth in the table above. The underwriters may exercise the option only for the purpose of covering excess sales, if any, made in connection with the distribution of the shares of our common stock offered hereby. The underwriters will offer any additional shares of our common stock that they purchase on the terms described in the preceding paragraph.

The underwriters have reserved for sale in a directed share program, at the initial public offering price, up to            shares of common stock in this offering for our employees and other related persons. Purchases of the reserved shares would reduce the number of shares available for sale to the general public. The underwriters

 

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will offer any reserved shares which are not so purchased to the general public on the same terms as the other shares being sold in this offering. Each of the purchasers in the directed share program will enter into the 180-day lock-up agreement with the underwriters described below.

The following table summarizes the compensation to be paid by us to the underwriters. This information assumes either no exercise or full exercise by the underwriters of their over-allotment option:

 

     Per Share      Total Without
Over-Allotment
     Total With
Over-Allotment
 

Public offering price

   $                        $                        $                    

Underwriting discount

   $         $         $     

Proceeds, before expenses

   $         $         $     

We estimate that our total expenses for this offering, excluding the underwriting discount, will be approximately $         million. We have agreed to reimburse the underwriters for certain of their expenses in an amount up to $                    .

We, each of our directors, executive officers and existing stockholders, who in the aggregate hold 100% of the shares of our common stock outstanding immediately prior to this offering (and, after giving effect to the subsidiary short-form merger with AAC that we expect to conduct subsequent to this offering, in the aggregate hold 94.1% of our outstanding shares of common stock) have agreed, and each of the purchasers in the directed share program will agree, subject to limited exceptions described below, for a period of 180 days after the date of this prospectus, not to, directly or indirectly, without the prior written consent of William Blair & Company, L.L.C. and Wells Fargo Securities, LLC:

 

    offer, sell, contract to sell, pledge, grant any option to purchase, make any short sale, establish an open “put equivalent position” within the meaning of Rule 16a-1(h) under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise transfer or dispose of, directly or indirectly, any shares of common stock, options or warrants to purchase any shares of common stock or any securities that are convertible into or exchangeable for, or that represent the right to receive, common stock, held of record or beneficially owned (within the meaning of Rule 13d-3 under the Exchange Act), or publicly disclose the intention to do any of the foregoing;

 

    enter into any swap or other arrangement that transfers, in whole or in part, any of the economic consequences associated with the ownership of any common stock; or

 

    make any demand or request for or exercise any right with respect to the registration of any shares of common stock or any securities convertible into or exchangeable for or that represent the right to receive common stock.

The lock-up agreements entered into by our directors, executive officers and existing stockholders and each of the purchasers in the directed share program do not extend to transfers of shares of common stock or securities convertible into or exchangeable for or that represent the right to receive shares of common stock (a) if the securities were acquired in open market transactions after the completion of this offering; (b) in the case of an individual, (i) by will or intestacy to his or her immediate family; or (ii) to a trust the beneficiaries of which are exclusively the transferor and/or a member or members of his or her immediate family; (c) to a charity or educational institution; (d) in the case of an entity or an individual who directly or indirectly controls an entity, to any stockholder, partner or member of, or owner of similar equity interests in, such entity, as the case may be; or (e) in the case of an entity, to another entity that is an affiliate of such entity; provided, however, that, (A) prior to any such transfer pursuant to clauses (b) through (e) above, each transferee shall execute an agreement, satisfactory to the representatives, pursuant to which each transferee shall agree to receive and hold such shares of common stock, or securities convertible into or exchangeable for or that represent the right to receive the common stock, subject to the foregoing restrictions, and there shall be no further transfer except in accordance with

 

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the foregoing restrictions, (B) no public disclosure or filing by any party (e.g., transferor or transferee) under the Exchange Act reporting a reduction in beneficial ownership of shares of common stock shall be required or shall be voluntarily made during the lock-up period in connection with such transfer and (C) any such transfer pursuant to clauses (b) through (e) above shall not involve a disposition for value. In determining whether to consent to a transaction prohibited by these restrictions, William Blair & Company, L.L.C. and Wells Fargo Securities, LLC will take into account various factors, including the length of time before the lock-up expires, the number of shares requested to be sold, the anticipated manner and timing of sale, the potential impact of the sale on the market for the common stock, the restrictions on publication of research reports that would be imposed by the rules of the Financial Industry Regulatory Authority and market conditions generally. During the lock-up period, we may (1) issue options, restricted stock units, restricted stock or other equity awards to acquire shares of common stock granted pursuant to our equity incentive plans that are described herein, as such plans may be amended, (2) issue shares of common stock upon the exercise of any such options, restricted stock units or other equity awards to acquire shares of common stock, (3) file registration statements on Form S-8 with respect to our benefit plans that are referred to herein and (4) issue of shares of common stock in an amount up to 5% of our outstanding shares of common stock in connection with a merger, acquisition or other transaction; provided, however, that in the case of an issuance pursuant to clauses (1), (2) or (4), the holders of such equity awards or shares of common stock agree to execute a lock-up agreement in the form described above (to the extent such holder has not previously signed a lock-up agreement). In August 2014, William Blair & Company, L.L.C. and Wells Fargo Securities, LLC consented to gifts by one of our directors, Mr. Lucius E. Burch, III, of an aggregate of 45,000 shares of our common stock to certain individuals.

We have agreed to indemnify the underwriters and their controlling persons against certain liabilities for misstatements in the registration statement of which this prospectus forms a part, including liabilities under the Securities Act, or to contribute to payments the underwriters may be required to make in respect thereof.

The representatives have informed us that the underwriters will not confirm, without client authorization, sales to their client accounts as to which they have discretionary authority. The representatives have also informed us that the underwriters intend to deliver all copies of this prospectus via electronic means, via hand delivery or through mail or courier services.

In connection with this offering, the underwriters and other persons participating in this offering may engage in transactions which affect the market price of the common stock. These may include stabilizing and over-allotment transactions and purchases to cover syndicate short positions. Stabilizing transactions consist of bids or purchases for the purpose of pegging, fixing or maintaining the price of the common stock. An over-allotment transaction, or short-sale, involves selling more shares of our common stock in this offering than are specified on the cover of this prospectus, which results in a syndicate short position. A short position may be “covered” or “naked.” In a “covered” short position, the number of shares of common stock created by a short sale is not greater than the number of shares of common stock in the underwriters’ option to purchase additional shares from us in this offering, which may be settled by exercising all or part of their over-allotment option or purchasing shares of common stock in the open market. In a “naked” short position, the number of shares of common stock created by a short sale is greater than the number of shares in the underwriters’ over-allotment option, which may be settled by purchasing shares of common stock in the open market. In addition, the representatives may impose a penalty bid. This allows the representatives to reclaim the selling concession allowed to an underwriter or selling group member if shares of our common stock sold by such underwriter or selling group member in this offering are repurchased by the representatives in stabilizing or syndicate short covering transactions. These transactions, which may be effected on the NYSE or otherwise, may stabilize, maintain or otherwise affect the market price of our common stock and could cause the price to be higher than it would be without these transactions. The underwriters and other participants in this offering are not required to engage in any of these activities and may discontinue any of these activities at any time without notice. We and the underwriters make no representation or prediction as to whether the underwriters will engage in such transactions or choose to discontinue any transactions engaged in or as to the direction or magnitude of any effect that these transactions may have on the price of our common stock.

 

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Prior to this offering, there has been no public market for our common stock. Consequently, we and the representatives of the underwriters have negotiated to determine the initial public offering price. Among the factors considered in determining the initial public offering price of the shares of our common stock, in addition to prevailing market conditions, were our historical performance, estimates of our business potential and earnings prospects, an assessment of our management and the consideration of the above factors in relation to market valuation of companies in related businesses.

Our common stock has been approved for listing on the NYSE under the symbol “AAC.”

The underwriters and their respective affiliates are full service financial institutions engaged in various activities, which may include sales and trading, commercial and investment banking, advisory, investment management, investment research, principal investment, hedging, market making, brokerage and other financial and non-financial activities and services. Certain of the underwriters and their respective affiliates have provided, and may in the future provide, a variety of these services to us and to persons and entities that have relationships with us, for which they received or will receive customary fees and expenses. In particular, an affiliate of Wells Fargo Securities, LLC is a lender under our Credit Facility and provides treasury services to us and mortgage financing, wealth management and other financial advisory services to certain of our executive officers. An affiliate of Avondale Partners, LLC has provided advisory services in connection with the refinancing of certain of our indebtedness. In addition, in the ordinary course of their various business activities, the underwriters and their respective affiliates, officers, directors and employees may purchase, sell or hold a broad array of investments and actively traded securities, derivatives, loans, commodities, currencies, credit default swaps and other financial instruments for their own account and for the accounts of their customers, and such investment and trading activities may involve or relate to our assets, securities or instruments (directly, as collateral securing other obligations or otherwise) or persons and entities who have relationships with us. The underwriters and their respective affiliates may also communicate independent investment recommendations, market color or trading ideas or publish or express independent research views in respect of such assets, securities or instruments and may at any time hold, or recommend to clients that they should acquire, long or short positions in such assets, securities and instruments.

Conflict of Interest

We intend to use a portion of the net proceeds that we receive from this offering to repay the outstanding balance on our revolving line of credit. Wells Fargo Securities, LLC, an underwriter in this offering, is an affiliate of Wells Fargo Bank, National Association, the lender under our revolving line of credit. Because we will use more than 5% of the net proceeds from this offering to reduce the outstanding balance under our revolving line of credit, Wells Fargo Securities, LLC will be deemed to have a “conflict of interest” with us within the meaning of Rule 5121 of the Conduct Rules of FINRA. Accordingly, this offering will be made in compliance with the applicable provisions of Rules 5110 and 5121 of the Conduct Rules regarding the underwriting of securities of a company with a member that has a conflict of interest within the meaning of those rules. Pursuant to Rule 5121, William Blair & Company, L.L.C. has served as the “qualified independent underwriter,” as defined by FINRA, and, in that capacity, has performed due diligence investigations and reviewed and participated in the preparation of the registration statement of which this prospectus forms a part. Wells Fargo Securities, LLC will not execute sales in discretionary accounts without the prior written specific approval of its customers.

Notice to Prospective Investors in the European Economic Area

In relation to each Member State of the European Economic Area (each, a “Relevant Member State”), no offer of shares may be made to the public in that Relevant Member State other than:

 

  A. to any legal entity which is a qualified investor as defined in the Prospectus Directive;

 

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  B. to fewer than 100 or, if the Relevant Member State has implemented the relevant provision of the 2010 PD Amending Directive, 150, natural or legal persons (other than qualified investors as defined in the Prospectus Directive), as permitted under the Prospectus Directive, subject to obtaining the prior consent of the representatives; or

 

  C. in any other circumstances falling within Article 3(2) of the Prospectus Directive,

provided that no such offer of shares shall require the company or the representatives to publish a prospectus pursuant to Article 3 of the Prospectus Directive or supplement a prospectus pursuant to Article 16 of the Prospectus Directive.

Each person in a Relevant Member State who initially acquires any shares or to whom any offer is made will be deemed to have represented, acknowledged and agreed that it is a “qualified investor” within the meaning of the law in that Relevant Member State implementing Article 2(1)(e) of the Prospectus Directive. In the case of any shares being offered to a financial intermediary as that term is used in Article 3(2) of the Prospectus Directive, each such financial intermediary will be deemed to have represented, acknowledged and agreed that the shares acquired by it in the offer have not been acquired on a non-discretionary basis on behalf of, nor have they been acquired with a view to their offer or resale to, persons in circumstances which may give rise to an offer of any shares to the public other than their offer or resale in a Relevant Member State to qualified investors as so defined or in circumstances in which the prior consent of the representatives has been obtained to each such proposed offer or resale.

The company, the representatives and their affiliates will rely upon the truth and accuracy of the foregoing representation, acknowledgment and agreement.

This prospectus has been prepared on the basis that any offer of shares in any Relevant Member State will be made pursuant to an exemption under the Prospectus Directive from the requirement to publish a prospectus for offers of shares. Accordingly any person making or intending to make an offer in that Relevant Member State of shares which are the subject of the offering contemplated in this prospectus may only do so in circumstances in which no obligation arises for the company or any of the underwriters to publish a prospectus pursuant to Article 3 of the Prospectus Directive in relation to such offer. Neither the company nor the underwriters have authorized, nor do they authorize, the making of any offer of shares in circumstances in which an obligation arises for the company or the underwriters to publish a prospectus for such offer.

For the purpose of the above provisions, the expression “an offer to the public” in relation to any shares in any Relevant Member State means the communication in any form and by any means of sufficient information on the terms of the offer and the shares to be offered so as to enable an investor to decide to purchase or subscribe for the shares, as the same may be varied in the Relevant Member State by any measure implementing the Prospectus Directive in the Relevant Member State and the expression “Prospectus Directive” means Directive 2003/71/EC (including the 2010 PD Amending Directive, to the extent implemented in the Relevant Member States) and includes any relevant implementing measure in the Relevant Member State and the expression “2010 PD Amending Directive” means Directive 2010/73/EU.

Notice to Prospective Investors in the United Kingdom

In addition, in the United Kingdom, this prospectus is being distributed only to, and is directed only at, and any offer subsequently made may only be directed at persons who are “qualified investors” (as defined in the Prospectus Directive) (i) who have professional experience in matters relating to investments falling within Article 19(5) of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005, as amended (the “Order”) and/or (ii) who are high net worth companies (or persons to whom it may otherwise be lawfully communicated) falling within Article 49(2)(a) to (d) of the Order (all such persons together being referred to as “relevant persons”). This prospectus must not be acted on or relied on in the United Kingdom by persons who are

 

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not relevant persons. In the United Kingdom, any investment or investment activity to which this prospectus relates is only available to, and will be engaged in with, relevant persons.

Notice to Prospective Investors in Switzerland

The shares may not be publicly offered in Switzerland and will not be listed on the SIX Swiss Exchange (“SIX”) or on any other stock exchange or regulated trading facility in Switzerland. This prospectus has been prepared without regard to the disclosure standards for issuance prospectuses under art. 652a or art. 1156 of the Swiss Code of Obligations or the disclosure standards for listing prospectuses under art. 27 ff. of the SIX Listing Rules or the listing rules of any other stock exchange or regulated trading facility in Switzerland. Neither this prospectus nor any other offering or marketing material relating to the shares or this offering may be publicly distributed or otherwise made publicly available in Switzerland.

Neither this prospectus nor any other offering or marketing material relating to this offering, the company or the shares have been or will be filed with or approved by any Swiss regulatory authority. In particular, this prospectus will not be filed with, and the offer of shares will not be supervised by, the Swiss Financial Market Supervisory Authority FINMA (FINMA), and the offer of shares has not been and will not be authorized under the Swiss Federal Act on Collective Investment Schemes (“CISA”). The investor protection afforded to acquirers of interests in collective investment schemes under the CISA does not extend to acquirers of shares.

 

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VALIDITY OF THE COMMON STOCK

The validity of the shares of common stock being offered by this prospectus will be passed upon for us by Ballard Spahr LLP, Las Vegas, Nevada, and certain other legal matters in connection with this offering will be passed upon for us by Bass, Berry & Sims PLC, Nashville, Tennessee. Certain legal matters in connection with this offering will be passed upon for the underwriters by Sidley Austin LLP, Chicago, Illinois.

EXPERTS

The (1) financial statements of American Addiction Centers, Inc. as of December 31, 2012 and 2013 and for the years then ended; (2) the financial statements of AJG Solutions, Inc. and B&B Holdings Intl LLC as of December 31, 2011 and August 31, 2012 and for the year ended December 31, 2011 and the eight months ended August 31, 2012; and (3) the statements of revenue and certain direct operating expenses of Greenhouse Real Estate, LLC for the periods from August 10, 2011 to December 31, 2011, the year ended December 31, 2012, and January 1, 2013 to October 7, 2013, all appearing in this prospectus have been so included in reliance on the reports of BDO USA, LLP, an independent registered public accounting firm, appearing elsewhere herein, given on the authority of said firm as experts in auditing and accounting.

WHERE YOU CAN FIND MORE INFORMATION

We have filed with the SEC a registration statement on Form S-1 under the Securities Act, with respect to the shares of common stock being offered by this prospectus. This prospectus, which constitutes a part of the registration statement, does not contain all of the information in the registration statement and its exhibits. For further information with respect to us and the common stock offered by this prospectus, you should refer to the registration statement and the exhibits filed as part of that document. Statements contained in this prospectus as to the contents of any contract or any other document referred to are not necessarily complete, and in each instance, we refer you to the copy of the contract or other document filed as an exhibit to the registration statement. Each of these statements is qualified in all respects by this reference.

You can read our SEC filings, including the registration statement, over the internet at the SEC’s website at http://www.sec.gov. You may also read and copy any document we file with the SEC at its public reference facilities at 100 F Street, N.E., Washington, D.C. 20549. You may also obtain copies of these documents at prescribed rates by writing to the Public Reference Section of the SEC at 100 F Street, N.E., Washington, D.C. 20549. Please call the SEC at 1-800-SEC-0330 for further information on the operation of the public reference facilities. You may also request a copy of these filings, at no cost, by writing or telephoning us at: 115 East Park Drive, Second Floor, Brentwood, Tennessee 37027 or (888) 300-3332.

Upon the closing of this offering, we will be subject to the information and periodic reporting requirements of the Exchange Act, as amended, and we will file periodic reports, proxy statements and other information with the SEC. These reports, proxy statements and other information will be available for inspection and copying at the public reference room and website of the SEC referred to above. We also maintain a website at www.americanaddictioncenters.com, at which you may access these materials free of charge as soon as reasonably practicable after they are electronically filed with, or furnished to, the SEC. The information contained in, or that can be accessed through, our website is not part of this prospectus.

 

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INDEX TO FINANCIAL STATEMENT S

 

American Addiction Centers, Inc. and Subsidiaries

  

Audited Financial Statements for the Years Ended December 31, 2012 and 2013

  

Report of Independent Registered Accounting Firm

     F-2   

Consolidated Balance Sheets as of December 31, 2012 and 2013

     F-3   

Consolidated Statements of Income for the Years Ended December 31, 2012 and 2013

     F-5   

Consolidated Statement of Stockholders’ Equity for the Years Ended December 31, 2012 and 2013

     F-6   

Consolidated Statements of Cash Flows for the Years Ended December 31, 2012 and 2013

     F-7   

Notes to Consolidated Financial Statements

     F-9   

AAC Holdings, Inc. and Subsidiaries

  

Condensed Consolidated Financial Statements for the Six Months Ended June 30, 2013 and 2014 (Unaudited)

  

Condensed Consolidated Balance Sheets as of December 31, 2013 and June 30, 2014

     F-45   

Condensed Consolidated Statements of Income for the Six Months Ended June 30, 2013 and 2014

     F-47   

Condensed Consolidated Statements of Cash Flows for the Six Months Ended June 30, 2013 and 2014

     F-48   

Condensed Consolidated Statement of Stockholders’ Equity for the Six Months Ended June 30, 2014

     F-50   

Notes to Condensed Consolidated Financial Statements

     F-51   

AJG Solutions, Inc. and B&B Holdings Intl LLC

  

Independent Auditor’s Report

     F-67   

Combined Balance Sheets as of December 31, 2011 and August 31, 2012

     F-68   

Combined Statements of Income and Shareholders’ / Members Equity for the Year Ended December  31, 2011 and the Eight Months Ended August 31, 2012

     F-69   

Combined Statements of Cash Flows for the Year Ended December  31, 2011 and the Eight Months Ended August 31, 2012

     F-70   

Notes to the Combined Financial Statements

     F-71   

Greenhouse Real Estate, LLC

  

Independent Auditor’s Report

     F-77   

Historical Statement of Revenues and Certain Direct Operating Expenses for the periods from August  10, 2011 (inception) to December 31, 2011, January 1, 2012 to December 31, 2012, and January 1, 2013 to October 7, 2013

     F-78   

Notes to Historical Statements of Revenues and Certain Direct Operating Expenses

     F-79   

 

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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

The Board of Directors and Stockholders

American Addiction Centers, Inc.

Brentwood, Tennessee

We have audited the accompanying consolidated balance sheets of American Addiction Centers, Inc. and subsidiaries as of December 31, 2012 and 2013, and the related consolidated statements of income, stockholders’ equity, and cash flows for the years then ended. These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these consolidated financial statements based on our audits.

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. Our audit included consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of American Addictions Centers, Inc. and subsidiaries as of December 31, 2012 and 2013, and the results of their operations and their cash flows for the years then ended, in conformity with accounting principles generally accepted in the United States of America.

/s/ BDO USA, LLP

Nashville, Tennessee

May 2, 2014

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In thousands, except per share amounts)

 

     December 31,  
     2012      2013  

Assets

     

Current assets

     

Cash and cash equivalents (variable interest entity—2012: $19; 2013: $441)

   $ 740       $ 2,012   

Accounts receivable, net of allowances of $4,278 and $13,320, respectively (variable interest entity—2012: $0; 2013: $169)

     20,645         24,567   

Deferred tax assets

     873         676   

Prepaid expenses and other current assets (variable interest entity—2012: $147; 2013: $173)

     769         2,274   
  

 

 

    

 

 

 

Total current assets

     23,027         29,529   

Property and equipment, net (variable interest entity—2012: $11,332; 2013: $29,257)

     15,327         37,008   

Goodwill

     10,863         10,863   

Intangible assets, net

     3,817         3,496   

Note receivable – related party

     300         250   

Other assets (variable interest entity—2012: $0; 2013: $142)

     264         492   
  

 

 

    

 

 

 

Total assets

   $ 53,598       $ 81,638   
  

 

 

    

 

 

 

— The assets denoted as assets of the consolidated variable interest entities (VIEs) can only be used to settle obligations of the consolidated VIEs.

 

 

See accompanying notes to consolidated financial statements.

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In thousands, except per share amounts)

 

     December 31,  
     2012     2013  

Liabilities, Mezzanine Equity and Stockholders’ Equity

    

Current liabilities

    

Accounts payable

   $ 1,385      $ 1,895   

Accrued liabilities (variable interest entity—2012: $320; 2013: $172)

     6,674        10,455   

Current portion of long-term debt (variable interest entity—2012: $170; 2013: $12,932)

     8,674        15,164   

Current portion of long-term debt – related party

     3,104        795   
  

 

 

   

 

 

 

Total current liabilities

     19,837        28,309   

Deferred tax liabilities (variable interest entity—2012: $0; 2013: $23)

     4,026        2,329   

Long-term debt, net of current portion (variable interest entity—2012: $7,211; 2013: $8,616)

     8,340        23,341   

Long-term debt – related party, net of current portion

     5,104        3,775   

Other long-term liabilities

            159   
  

 

 

   

 

 

 

Total liabilities

     37,307        57,913   
  

 

 

   

 

 

 

Commitments and contingencies (Note 16)

    

Mezzanine equity including noncontrolling interest (see Note 11)

    

Series B Preferred Stock

     1,000          

Common stock

     10,613        10,442   

Noncontrolling interest–Series A Preferred (variable interest entity)

            1,400   
  

 

 

   

 

 

 

Total mezzanine equity including noncontrolling interest

     11,613        11,842   
  

 

 

   

 

 

 

Stockholders’ equity

    

Common stock, $0.001 par value; 15,000,000 shares authorized; 983,612 and 2,481,114 issued and 983,612 and 2,036,680 outstanding as of December 31, 2012 and 2013, respectively

     1        2   

Common stock subscribed, net of subscription receivable of $58 in 2013

            42   

Additional paid-in capital (distributions in excess of paid-in-capital)

     (677     9,450   

Treasury stock, at cost

     (17     (3,671

Retained earnings

     1,574        2,360   
  

 

 

   

 

 

 

Total stockholders’ equity of American Addiction Centers, Inc.

     881        8,183   

Noncontrolling interest

     3,797        3,700   
  

 

 

   

 

 

 

Total stockholders’ equity including noncontrolling interest

     4,678        11,883   
  

 

 

   

 

 

 

Total liabilities, mezzanine equity and stockholders’ equity

   $ 53,598      $ 81,638   
  

 

 

   

 

 

 

— The denoted VIEs’ liabilities are only claims against the general credit of the Company to the extent that the Company is liable under its guarantee of the VIEs’ notes payable to a financial institution of $7,381 and $21,548 at December 31, 2012 and 2013, respectively.

 

See accompanying notes to consolidated financial statements.

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF INCOME

(In thousands, except share and per share amounts)

 

     Years ended
December 31,
 
     2012      2013  

Revenues

   $ 66,035       $ 115,741   

Operating expenses

     

Salaries, wages and benefits

     25,680         46,856   

Advertising and marketing

     8,667         13,493   

Professional fees

     5,430         10,277   

Client related services

     8,389         7,986   

Other operating expenses

     6,384         11,615   

Rentals and leases

     3,614         4,634   

Provision for doubtful accounts

     3,344         10,950   

Litigation settlement

             2,588   

Restructuring

             806   

Depreciation and amortization

     1,288         3,003   
  

 

 

    

 

 

 

Total operating expenses

     62,796         112,208   
  

 

 

    

 

 

 

Income from operations

     3,239         3,533   

Interest expense

     980         1,390   

Other expense, net

     12         36   
  

 

 

    

 

 

 

Income before income tax expense

     2,247         2,107   

Income tax expense

     1,148         615   
  

 

 

    

 

 

 

Net income

     1,099         1,492   

Less: net loss (income) attributable to noncontrolling interest

     405         (706
  

 

 

    

 

 

 

Net income attributable to American Addiction Centers, Inc.

     1,504         786   

Deemed contribution-redemption of Series B Preferred

             1,000   
  

 

 

    

 

 

 

Net income available to American Addiction Centers, Inc. common stockholders

   $ 1,504       $ 1,786   
  

 

 

    

 

 

 

Basic earnings per share

   $ 0.19       $ 0.20   

Diluted earnings per share

   $ 0.19       $ 0.20   

Weighted-average shares outstanding:

     

Basic

     7,770,359         8,819,062   

Diluted

     7,869,017         9,096,660   

 

See accompanying notes to consolidated financial statements.

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY

(In thousands, except share amounts)

 

    Common Stock                

Additional
Paid-in

Capital/

(Distributions

in Excess of

               

Total

Stockholders’

Equity
(Deficit)

of American

Addiction

    Non-    

Total

Stockholders’

 
    Shares
Outstanding
    Amount     Subscribed     Subscriptions
Receivable
    Paid-in
Capital)
    Treasury
Stock
    Retained
Earnings
    Centers,
Inc.
    Controlling
Interests
    Equity
(Deficit)
 

Balance at December 31, 2011

    94,744      $      $      $      $ (7,789   $ (17   $ 70      $ (7,736   $      $ (7,736

Warrants issued with subordinated debt

                                143                      143               143   

Common stock issued in connection with business combination (of which 226,416 shares are restricted)

    888,868        1                      5,568                      5,569               5,569   

Initial consolidation of VIEs

                                                            4,284        4,284   

Distribution to noncontrolling interest holders

                                                            (82     (82

Common stock granted under stock incentive plan

                                1,401                      1,401               1,401   

Net income (loss)

                                              1,504        1,504        (405     1,099   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Balance at December 31, 2012

    983,612        1                      (677     (17     1,574        881        3,797        4,678   

Common stock issued

    906,439        1        100        (58     7,428                      7,471               7,471   

Redemption of mezzanine Series B Preferred Stock

                                1,000                      1,000               1,000   

Redemption of common stock

                                (1,238                   (1,238            (1,238

Common stock granted and issued under stock incentive plan

    348,050                             937                      937               937   

Conversion of debt to equity

    243,013                             2,000                      2,000               2,000   

Redemption of common stock

    (444,434                                 (3,654            (3,654            (3,654

Initial consolidation of VIEs

                                                            3,020        3,020   

Redemptions of noncontrolling interest of variable interest entities

                                                            (2,990     (2,990

Distribution to noncontrolling interest holders, net

                                                            (815     (815

Net income

                                              786        786        706        1,492   

Noncontrolling interest — Series A Preferred Dividend accrued

                                                            (18     (18
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Balance at December 31, 2013

    2,036,680      $ 2      $ 100      $ (58   $ 9,450      $ (3,671   $ 2,360      $ 8,183      $ 3,700      $ 11,883   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

See accompanying notes to consolidated financial statements.

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(In thousands)

 

     Years ended December 31,  
         2012             2013      

Cash flows from operating activities:

    

Net income

   $ 1,099      $ 1,492   

Adjustments to reconcile net income to net cash provided by operating activities:

    

Provision for doubtful accounts

     3,344        10,950   

Depreciation and amortization

     1,288        3,003   

Loss on disposal of property and equipment

            395   

Equity compensation

     1,401        979   

Amortization of discount on notes payable

     48        32   

Deferred income taxes

     37        (1,500

Decrease in fair value of contingent related-party note payable

            (91

Changes in operating assets and liabilities:

    

Accounts receivable

     (11,879     (14,810

Prepaid expenses and other assets

     (763     (1,287

Accounts payable

     995        510   

Accrued liabilities

     4,499        3,611   

Other long term liabilities

            159   
  

 

 

   

 

 

 

Net cash provided by operating activities

     69        3,443   
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Acquisitions, net of cash acquired

     (2,500       

Cash acquired in consolidation of variable interest entity

            210   

Purchase of property and equipment

     (6,264     (12,975

Proceeds on sale of minority interest investment

     150          

Funding of notes receivable, related party

     (50       

Collection of notes receivable, related party

     268        50   

(Purchase) reimbursement of other assets

     500        (429
  

 

 

   

 

 

 

Net cash used in investing activities

     (7,896     (13,144
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Proceeds from revolving line of credit, net

     2,635        5,851   

Proceeds from note payable

     6,589        9,150   

Proceeds from note payable – related party

     1,500          

Proceeds from sale of subordinated notes payable

     990          

Payments on notes payable and capital leases

     (863     (2,433

Repayment of notes payable – related party

     (2,295     (1,554

Repayment of subordinated notes payable

     (40       

Redemption of common stock

            (5,063

Proceeds from sale of common stock

            7,429   

Contributions from noncontrolling interest

            1,979   

Distributions to noncontrolling interest

     (82     (1,396

Redemptions of noncontrolling interest

            (2,990
  

 

 

   

 

 

 

Net cash provided by financing activities

     8,434        10,973   
  

 

 

   

 

 

 

Net increase in cash and cash equivalents

     607        1,272   

Cash and cash equivalents, beginning of year

     133        740   
  

 

 

   

 

 

 

Cash and cash equivalents, end of year

   $ 740      $ 2,012   
  

 

 

   

 

 

 

(continued on next page)

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(In thousands)

 

     Year ended December 31,  
         2012             2013      

Supplemental disclosures of cash flow information:

  

Cash and cash equivalents paid for:

  

Interest, net of capitalized interest of $0 and $75 in 2012 and 2013, respectively

   $ 730      $ 1,265   
  

 

 

   

 

 

 

Income taxes, net of refunds of $9 and $251 in 2012 and 2013, respectively

   $ 53      $ 2,870   
  

 

 

   

 

 

 

Supplemental information on non-cash investing and financing transactions:

  

Acquisitions:

  

Purchase price

   $ 14,591      $   

Seller financed debt

     (6,522       

Buyer common stock issued

     (5,569       
  

 

 

   

 

 

 

Cash paid for acquisition

   $ 2,500      $   
  

 

 

   

 

 

 

Consolidation of variable interest entities:

  

Assets of variable interest entities, excluding cash

   $ (7,760   $ (17,407

Liabilities of variable interest entities and noncontrolling interest, excluding cash

     7,760        17,617   
  

 

 

   

 

 

 

Cash of variable interest entities

   $      $ 210   
  

 

 

   

 

 

 

Conversion of notes payable into common stock

   $      $ 2,000   
  

 

 

   

 

 

 

Acquisition of equipment through capital lease

   $      $ (1,163
  

 

 

   

 

 

 

Sale of property to a variable interest entity

   $      $ 6,708   
  

 

 

   

 

 

 

Notes payable in connection with the sale of property to a consolidated variable interest entity

   $      $ (6,708
  

 

 

   

 

 

 

Retirement of Series B Preferred Stock

   $      $ 1,000   
  

 

 

   

 

 

 

Noncontrolling interest — Series A Preferred accrued dividends of a variable interest entity

   $      $ 18   
  

 

 

   

 

 

 

 

 

See accompanying notes to consolidated financial statements.

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

1. Description of Business

American Addiction Centers, Inc. (formerly known as Forterus, Inc.), a Nevada corporation (collectively with its subsidiaries, the “Company”), was incorporated on February 27, 2007. The Company, headquartered in Brentwood, Tennessee, provides substance abuse treatment services for individuals with drug and alcohol addiction. The Company also provides treatment services for clients struggling with behavioral health disorders, including disorders associated with obesity. Currently, the Company, through its subsidiaries, operates six substance abuse treatment facilities located in Texas, California, Florida and Nevada and a facility in Tennessee that provides treatment services for men and women who struggle with obesity-related behavioral disorders. During 2012 the Company had arrangements with four treatment facilities in California to provide addiction and chemical dependency services to clients sourced by the Company. The Company discontinued using three of these treatment facilities in the second half of 2012 and the final arrangement was terminated in April 2013. On March 7, 2012, the Greenhouse treatment facility in Texas obtained its license for 70 residential beds and began accepting clients. On January 1, 2013, the Desert Hope treatment facility in Las Vegas, Nevada obtained its license for 148 residential beds and began accepting clients. In the third quarter of 2013, the Company, through a wholly owned subsidiary, began providing laboratory services to some of the Company’s treatment facilities.

2. Basis of Presentation

Principles of Consolidation

The Company conducts its business through limited liability companies and C-corporations, each of which is a wholly owned subsidiary of the Company. The accompanying consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries, the accounts of variable interest entities (“VIEs”) in which the Company is the primary beneficiary, and certain professional groups through rights granted to the Company by contract to manage and control an entity’s business.

The Company consolidated one real estate VIE in 2012 and consolidated another two VIEs in 2013. All three of these VIEs were acquired in 2013 by Behavioral Healthcare Realty, LLC (“BHR”), which is also a VIE. The Company also consolidated five professional groups (“Professional Groups”) that constitute VIEs in 2013. BHR leases two treatment facilities to the Company under long-term triple net leases and is renovating and constructing additional treatment facilities that it will lease to the Company. The Company is the primary beneficiary as a result of its guarantee of BHR’s debt. The Company has management services arrangements with five Professional Groups that provide medical services to the Company’s treatment facilities. The Professional Groups, which the Company controls, are responsible for the supervision and delivery of medical services. Based on the Company’s ability to direct the activities that most significantly impact the economic performance of the Professional Groups, provide necessary funding and the obligation and likelihood of absorbing all expected gains and losses, the Company has determined that it is the primary beneficiary. The accompanying consolidated balance sheets at December 31, 2012 and December 31, 2013 include assets of $11.5 million and $30.2 million, respectively, and liabilities of $7.7 million and $21.7 million, respectively, related to the VIEs. The accompanying consolidated statements of income for the years ended December 31, 2012 and 2013 include net (loss) income attributable to noncontrolling interest of ($0.4) million and $0.7 million, respectively, related to the VIEs. For the years ended December 31, 2012 and 2013, the VIEs generated the following cash flows:

 

     Year Ended December 31,  
         2012             2013      

Net cash provided by (used in) operating activities

   $ (196   $ 1,544   

Net cash used in investing activities

     (3,697     (1,260

Net cash provided by financing activities

     3,878        11   

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

All significant intercompany balances and transactions are eliminated in consolidation.

3. Summary of Significant Accounting Policies

Use of Estimates

The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the United States of America (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses at the date and for the periods that the consolidated financial statements are prepared. On an ongoing basis, the Company evaluates its estimates, including those related to insurance adjustments, provisions for doubtful accounts, intangible assets, long-lived assets, deferred revenues and income taxes. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances. Actual results could materially differ from those estimates.

General and Administrative Costs

The majority of the Company’s expenses are “cost of revenue” items. Costs that could be classified as general and administrative expenses include the Company’s corporate overhead costs, which were $17.3 million and $28.1 million for the years ended December 31, 2012 and 2013, respectively.

Revenues

The Company provides services to its clients in both inpatient and outpatient treatment settings. Revenues are recognized when services are performed at estimated net realizable value from clients, third-party payors and others for services provided. The Company receives the vast majority of payments from commercial payors at out-of-network rates. Client service revenues are recorded at established billing rates less adjustments to estimate net realizable value. Adjustments are recorded to state client service revenues at the amount expected to be collected for the service provided based on historic adjustments for out-of-network services not under contract. Prior to admission, each client’s insurance is verified and the client self-pay amount is determined. The client self-pay portion is generally collected upon admission. In some instances, clients will pay out-of-pocket as services are provided or will make a deposit and negotiate the remaining payments as part of the services. These out-of-pocket payments are included in accrued liabilities in the accompanying consolidated balance sheets and revenues related to these payments are deferred and recognized over the period services are provided. From time to time, scholarships may be provided to a limited number of clients. We do not recognize revenues for care provided via scholarships.

For the year ended December 31, 2012, approximately 16.5% of the Company’s revenues were reimbursed by Blue Cross Blue Shield of California and 11.3% were reimbursed by Aetna. No other payor accounted for more than 10% of revenue reimbursements for the year ended December 31, 2012.

For the year ended December 31, 2013, approximately 12.3% of the Company’s revenues were reimbursed by Blue Cross Blue Shield of California, 12.1% were reimbursed by Aetna, and 10.3% were reimbursed by United Behavioral Health. No other payor accounted for more than 10% of revenue reimbursements for the year ended December 31, 2013.

In cases where the demand for services exceeded capacity, the Company entered into contractual arrangements with other parties to provide services. Management evaluated and determined the Company was the principal party to the services provided. Revenues generated through the Company’s contractual arrangements are included in revenues at their expected realizable amount while the subcontracted service payments

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

made are included in client related services. The need for these contractual arrangements decreased as the Company increased its bed capacity in the second half of 2012 and further decreased with the increased bed capacity in the first quarter of 2013 as a result of the opening of Desert Hope.

Allowance for Contractual and Other Discounts

The Company derives the vast majority of its revenues from commercial payors at out-of-network rates. Management estimates the allowance for contractual and other discounts based on its historical collection experience. The services authorized and provided and related reimbursement are often subject to interpretation and negotiation that could result in payments that differ from the Company’s estimates.

Accounts Receivable and Allowance for Doubtful Accounts

Accounts receivable primarily consists of amounts due from third-party payors (non-governmental) and private pay clients and is recorded net of contractual discounts. The Company’s ability to collect outstanding receivables is critical to its results of operations and cash flows. Accounts receivable is reported net of an allowance for doubtful accounts, which is management’s best estimate of accounts receivable that could become uncollectible in the future. Accordingly, accounts receivable reported in the Company’s consolidated financial statements is recorded at the net amount expected to be received. The Company’s primary collection risks are (i) the risk of overestimating net revenues at the time of billing that may result in the Company receiving less than the recorded receivable, (ii) the risk of non-payment as a result of commercial insurance companies denying claims, (iii) the risk that clients will fail to remit insurance payments to the Company when the commercial insurance company pays out-of-network claims directly to the client, (iv) resource and capacity constraints that may prevent the Company from handling the volume of billing and collection issues in a timely manner, (v) the risk that clients do not pay the Company for their self-pay balance (including co-pays, deductibles and any portion of the claim not covered by insurance) and (vi) the risk of non-payment from uninsured clients. The Company’s allowance for doubtful accounts is based on historical experience, but management also takes into consideration the age of accounts, creditworthiness and current economic trends when evaluating the adequacy of the allowance for doubtful accounts. An account is written off only after the Company has pursued collection efforts or otherwise determines an account to be uncollectible.

At December 31, 2012, 15.1% of accounts receivable was from Blue Cross Blue Shield of California and 12.6% was from United Behavioral Health. No other payor accounted for more than 10% of accounts receivable at December 31, 2012. At December 31, 2013, 19.5% of accounts receivable was from Blue Cross Blue Shield of California, 12.2% was from Anthem Blue Cross Blue Shield of Colorado and 10.9% was from United Behavioral Health. No other payor accounted for more than 10% of accounts receivable at December 31, 2013.

A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands):

 

Description

   Balance at
beginning of
year
     Additions
charged to
Provision for
Doubtful
Accounts
     Accounts
written off, net
of recoveries
    Balance at
end of year
 

Allowance for doubtful accounts for the year ended:

          

December 31, 2012

   $ 1,233       $ 3,344       $ (299   $ 4,278   

December 31, 2013

     4,278         10,950         (1,908     13,320   

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

Cash and Cash Equivalents

The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents.

Property and Equipment

Property and equipment are stated at cost, net of accumulated depreciation and amortization. Expenditures for maintenance and repairs are charged to expense as incurred. The Company capitalizes interest on construction projects and such interest is included in the cost of the related asset. Assets held for development are classified as construction in progress and the Company does not depreciate these assets until they are placed in service. Leasehold improvements are amortized over their estimated useful lives or the remaining lease period, whichever is less. Assets under capital leases are amortized over the lease term or in the event of transfer of ownership at the end of the lease over the economic life of the leased asset. Amortization expense related to assets under capital lease is included with depreciation and amortization expense in the consolidated statements of income. Depreciation is calculated using the straight-line method over the estimated economic useful lives of the assets, as follows:

 

     Range of Lives  

Computer software and equipment

     3 years   

Buildings

     36 years   

Furniture, fixtures and equipment

     5 years   

Vehicles

     5 years   

Equipment under capital lease

     3–5 years   

Leasehold improvements

    
 
Life of the asset or lease,
whichever is less
  
  

Goodwill and Intangible Assets

The Company has only one operating segment, substance abuse/behavioral healthcare treatment services, for segment reporting purposes. The substance abuse/behavioral healthcare treatment services operating segment represents one reporting unit for purposes of the Company’s goodwill impairment test. Goodwill represents the excess of the purchase price over the fair value of the identifiable net assets acquired. Goodwill and intangible assets with indefinite lives are not amortized, but instead tested for impairment at least annually or whenever events or changes in circumstances indicate the carrying value may not be recoverable. The Company has no intangible assets with indefinite useful lives other than goodwill. The Company considers the following to be important factors that could trigger an impairment review: significant underperformance relative to historical or projected future operating results; identification of other impaired assets within a reporting unit; significant adverse changes in business climate or regulations; significant changes in senior management; significant changes in the manner of use of the acquired assets or the strategy for the Company’s overall business; and significant negative industry or economic trends.

Goodwill is assessed for impairment using a fair value approach at the reporting unit level. The goodwill impairment test is a two-step process, if necessary. The provisions for the accounting standard of goodwill provide an entity with the option to assess qualitative factors to determine whether the existence of events or circumstances leads to the determination that it is more likely than not that the fair value of a reporting unit is less than its carrying amount. This qualitative assessment is referred to as a “step zero” approach. If based on the qualitative factors, an entity determines it is not more likely than not that the fair value of a reporting unit is less than its carrying value, the entity may skip the two-step impairment test required by prior accounting guidance. If an entity determines otherwise or, at the option of the entity, if a step zero is not performed, step one of the two-step impairment test is required. Under step one, the fair value of the reporting unit is compared with its carrying

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

value (including goodwill). If the fair value of the reporting unit is less than its carrying value, an indication of goodwill impairment exists for the reporting unit and the entity must perform step two of the impairment test. Under step two, an impairment loss is recognized for any excess of the carrying amount of the reporting unit’s goodwill over the implied fair value of that goodwill. The implied fair value of goodwill is determined by allocating the fair value of the reporting unit in a manner similar to a purchase price allocation and the residual fair value after this allocation is the implied fair value of the reporting unit goodwill. Fair value of the reporting unit is determined using a discounted cash flow analysis. If the fair value of the reporting unit exceeds its carrying value, step two does not need to be performed. Impairment shall be recognized to the extent that the carrying amount of goodwill exceeds its implied fair value. In performing step one of the goodwill impairment test, the Company compares the carrying amount of the reporting unit to the estimated fair value.

In assessing the recoverability of goodwill, the Company considers historical results, current operating trends and results and makes estimates and assumptions about revenues, margins and discount rates based on the Company’s budgets, business plans, economic projections and anticipated future cash flows. Each of these factors contains inherent uncertainties, and management must exercise substantial judgment and discretion in evaluating and applying these factors.

The annual goodwill impairment test is performed December 31 each year, utilizing the two-step test. The Company concluded the carrying value of the reporting unit as of December 31, 2013 did not exceed its fair value, and thus no indication of impairment was present. The fair value of goodwill exceeded the carrying value by $3.3 million at December 31, 2013.

The Company’s other intangible assets principally relate to trademarks and marketing intangibles and non-compete agreements. Trademarks and marketing intangibles are amortized over a period of ten years. Non-compete agreements are amortized over the five-year term of the agreements.

Long-Lived Asset Impairment

Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net undiscounted cash flows expected to be generated by the asset. Impairment is measured by the amount by which the carrying value of the assets exceeds the fair value of the assets. The Company did not identify any indicators of impairment as of December 31, 2012 and 2013.

Accrued Liabilities

The Company’s accrued liabilities, reflected as a current liability in the accompanying consolidated balance sheet, consist of the following (in thousands):

 

     Year Ended December 31,  
           2012                  2013        

Accrued payroll liabilities

   $ 1,263       $ 4,685   

Accrued litigation settlement

             2,588   

Accrued legal fees

     190         706   

Income taxes payable

     1,003         53   

Accrued expenses – related party

             33 (a)  

Other

     4,218         2,390   
  

 

 

    

 

 

 

Total accrued liabilities

   $ 6,674       $ 10,455   
  

 

 

    

 

 

 

 

(a) Accrued expenses payable to the Company’s Chief Executive Officer.

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

 

Segments

The focus of all Company operations is centered on a single service, substance abuse/behavioral healthcare treatment. As such, the Company has one operating segment. The Company is organized and operates as one reportable segment, comprised of various treatment facilities located in the United States. The treatment facilities operate in the same industry and have similar economic characteristics, services and clients. Management has the ability to direct and serve clients in any of these facilities, which allows management to operate the Company’s business and analyze its revenues on a system-wide basis rather than focusing on any individual facility. The Company’s chief operating decision maker evaluates performance and manages resources based on the results of the consolidated operations as a whole.

Advertising Expenses

Advertising costs are expensed as the related activity occurs.

Stock-Based Compensation

The Company accounts for stock-based compensation to employees and consultants using a fair-value based method for costs related to all share-based payments. The Company estimates the fair value of employee restricted stock awards on the date of grant based on the appraised fair value. The Company uses the Black-Scholes valuation model to determine grant date fair value for stock option awards. The fair value of the portion of the award that is ultimately expected to vest is recognized as expense on a straight-line basis over the requisite service periods in the Company’s consolidated statements of income.

Earnings Per Share

Basic and diluted earnings per share are calculated based on the weighted-average number of shares outstanding in each period and dilutive stock options, non-vested shares and warrants, to the extent such securities have a dilutive effect on earnings per share using the treasury stock method. The two-class method determines earnings per share for each class of common stock and participating preferred stock and their respective participation rights in undistributed earnings. Effective with the elimination of the Series B Preferred Stock in the first quarter of 2013, the Company no longer has two classes of stock.

Income Taxes

The Company accounts for income taxes using the asset and liability method. Under the asset and liability method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled.

The effect on the deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. A valuation allowance is provided for significant deferred tax assets when it is more likely than not that such assets will not be recovered.

The Company’s practice is to recognize interest and/or penalties related to income tax matters in income tax expense.

For the years ended December 31, 2012 and 2013, the Company had no accrued interest or penalties related to income tax matters in income tax expense.

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

 

VIEs included in the accompanying consolidated financial statements consist of various corporations and partnerships. Tax benefits, expenses, assets and liabilities have been applied to the corporations following the same methodology described above. However, because partnerships are characterized as flow through entities for federal and certain state income tax purposes, taxes for the VIEs that are considered partnerships are not recorded in the accompanying consolidated financial statements, except for certain state taxes imposed at the entity level. Taxes that are imposed on the partners of these partnerships are not included in the accompanying consolidated financial statements. The Company is not a partner in any of these VIEs, therefore none of the flow through taxes from these VIEs are the responsibility of the Company.

Fair Value Measurements

Fair value, for financial reporting purposes, is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants.

Disclosure is required about how fair value was determined for assets and liabilities and following a hierarchy for which these assets and liabilities must be grouped, based on significant levels of inputs as follows: Level 1—quoted prices in active markets for identical assets or liabilities; Level 2—quoted prices in active markets for similar assets and liabilities and inputs that are observable for the asset or liability; or Level 3—unobservable inputs for the asset or liability, such as discounted cash flow models or valuations. The determination of where assets and liabilities fall within this hierarchy is based upon the lowest level of input that is significant to the fair value measurement.

Concentration of Credit Risk

Cash and cash equivalents are maintained at financial institutions and, at times, balances may exceed federally insured limits. The Company has never experienced any losses related to these balances. All of the non-interest bearing cash balances were fully insured at December 31, 2012 as a result of a temporary federal program in effect from December 31, 2010 through December 31, 2012. Under the program, there was no limit to the amount of insurance for eligible accounts. In 2013, insurance coverage reverted to $250,000 per depositor at each financial institution. At December 31, 2012 and 2013, the Company had $0 and $1.4 million, respectively, on deposit with banks in excess of federally insured limits.

Comprehensive Income

As of December 31, 2012 and 2013, the Company did not have any components of other comprehensive income. As such, comprehensive income equaled net income for each of the periods presented in the accompanying consolidated statements of income.

Recent Accounting Standards

There are no recently issued accounting pronouncements that are expected to have a material impact on the Company’s financial condition, results of operations or cash flows.

Reclassifications

Certain reclassifications have been made to the 2012 consolidated financial statements to conform to the 2013 presentation. The reclassifications had no impact on the Company’s financial position, results of operations or cash flows.

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

 

4. Earnings Per Share

Earnings per share (“EPS”) is calculated using the two-class method required for participating securities. Series B Preferred Stock was entitled to dividends at the rate equal to that of common stock.

Undistributed earnings allocated to these participating securities are subtracted from net income in determining net income attributable to common stockholders. Net losses, if any, are not allocated to these participating securities. Basic EPS is computed by dividing net income attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. Common shares outstanding include both the common shares classified as mezzanine equity and those classified as equity.

For the calculation of diluted EPS, net income attributable to common stockholders for basic EPS is adjusted by the effect of dilutive securities, including awards under stock-based payment arrangements and 150,944 shares issued in connection with the TSN Acquisition (see Note 5). Diluted EPS attributable to common stockholders is computed by dividing net income attributable to common stockholders by the weighted-average number of fully diluted common shares outstanding during the period.

The following tables reconcile the numerator and denominator used in the calculation of basic and diluted EPS for the years ended December 31, 2012 and 2013 (in thousands except share and per share amounts):

 

     Year Ended December 31,  
           2012                  2013        

Numerator

     

Net income attributable to American Addiction

Centers, Inc.

   $ 1,504       $ 786   

Less: Redemption of Series B Preferred deemed contribution

             1,000   
  

 

 

    

 

 

 

Net income attributable to common shares

   $ 1,504       $ 1,786   
  

 

 

    

 

 

 

Denominator

     

Weighted-average shares outstanding – basic

     7,770,359         8,819,062   

Dilutive securities

     98,658         277,598   
  

 

 

    

 

 

 

Weighted-average shares outstanding – diluted

     7,869,017         9,096,660   
  

 

 

    

 

 

 

Basic earnings per share

   $ 0.19       $ 0.20   

Diluted earnings per share

   $ 0.19       $ 0.20   

The Company has included common stock that is classified as mezzanine equity in the denominator for both basic and diluted EPS calculations in 2012 and 2013.

5. Acquisitions

Acquisition of AJG Solutions, Inc. and B&B Holdings Intl LLC

On August 31, 2012, the Company acquired certain assets of AJG Solutions, Inc. (d/b/a Treatment Solutions Network) and its subsidiaries (collectively, “AJG”) and the equity of B&B Holdings Intl LLC (“B&B”, and collectively with the acquisition of the AJG assets, the “TSN Acquisition”). AJG provides referral services for addiction rehabilitation services and centers and B&B provides addiction rehabilitation services through treatment facilities in Florida and a treatment facility in New Jersey (until its closure in June 2013). At the time of the TSN Acquisition, AJG and B&B were jointly owned by two individuals (the “TSN Sellers”), each of whom became employees of the Company following the acquisition. In connection with the TSN Acquisition, the Company issued 888,868 shares of common stock (662,452 unrestricted shares and 226,416 restricted shares (at a fair value of $6.27 per share as estimated by the Company’s management)), valued collectively at $5.6 million;

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

paid cash of $2.5 million from proceeds received from bank financing; and issued $6.5 million of subordinated seller notes to the TSN Sellers. The purchase agreement includes contingent provisions for a subsequent purchase price adjustment at the maturity of the seller debt financing to withhold at settlement up to $1.5 million in cash and the 226,416 restricted shares of common stock (with an aggregate value of $1.4 million at the time the TSN Acquisition closed) if certain operational performance metrics are not achieved during the three-year term of the seller note. The aggregate purchase price, including the fair value of the contingent consideration, was $14.6 million. The Company consummated the TSN Acquisition to expand the scope of the Company’s services geographically and gain synergies in obtaining leads for new clients.

The purchase price was based upon arms-length negotiations between the Company and the TSN Sellers that resulted in a premium to the fair value of the net assets acquired (including identifiable intangible assets) and, correspondingly, the recognition of goodwill. The amount recorded for goodwill is consistent with the Company’s intentions for the acquisition.

The acquisition was accounted for as a business combination. The Company recorded the transaction based upon the fair value of the consideration paid to the TSN Sellers. This consideration was allocated to the assets acquired and liabilities assumed at the acquisition date based on their fair values as follows (in thousands):

 

Accounts receivable

   $ 5,408   

Prepaid expenses and other assets

     273   

Property and equipment

     379   

Goodwill

     8,536   

Intangible assets

     3,939   
  

 

 

 

Total Assets acquired

     18,535   
  

 

 

 

Accrued liabilities

     345   

Deferred tax liabilities

     3,599   
  

 

 

 

Total liabilities assumed

     3,944   
  

 

 

 

Net assets acquired

   $ 14,591   
  

 

 

 

In connection with the TSN Acquisition, the Company entered into a license agreement with AJG. Under the license agreement, AJG granted the Company a royalty-free license to use certain trademarks and certain other intangible assets related to the operations acquired in the TSN Acquisition. The license has a three-year term, at the end of which period the licensed assets will be assigned to the Company, subject to the satisfaction of certain conditions.

The goodwill and identifiable intangible assets recognized are not deductible for income tax purposes. Acquisition related costs total $0.1 million and were expensed in other operating expenses in the consolidated statement of income for the year ended December 31, 2012. There was no adjustment to the purchase price allocation in 2013 as the result of finalizing certain TSN Acquisition tax returns.

The following provides a breakdown of the identifiable intangible assets, valuation method applied in arriving at fair value, their assigned values and expected lives (in thousands, except years):

 

Intangible Asset

  

Valuation Method

   Assigned
Value
     Estimated
Life In Years
 

Non-compete agreements

   With and without method (1)    $ 1,257         5   

Trademarks and marketing intangibles

   Relief from royalty (2)      2,682         10   
     

 

 

    

Total identified intangible assets

      $ 3,939      
     

 

 

    

 

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(1) The with and without method estimates an intangible asset’s value based on the business value “with” the non-compete in place and “without” the non-compete in place.

(2) The relief from royalty method is an earnings approach that assesses the royalty savings the entity realizes as a result of owning the asset and not having to pay a third party a license fee for its use.

Some of the more significant estimates and assumptions inherent in the estimate of the fair value of the identifiable acquired intangible assets include all those associated with forecasting cash flows and profitability. The primary assumptions used for the determination of the fair value of the purchased intangible assets were generally based upon the present value of anticipated cash flows discounted at rates generally ranging from 16.1% to 19.0%. Estimated years of future cash flows and earnings generally follow the range of estimated remaining useful lives for each intangible asset.

The results of operations for AJG and B&B from the acquisition date of August 31, 2012 are included in the consolidated statement of income for the year ended December 31, 2012, and include revenues of $11.0 million and income before income taxes of $5.8 million. The following presents the unaudited pro forma revenues and income before income taxes of the combined entity had the TSN Acquisition occurred on the first day of the period presented (in thousands):

 

     Revenues      Income before
income taxes
 

Combined pro forma from January 1, 2012 – December 31, 2012

   $ 84,512       $ 6,288   

Consolidation of Concorde Real Estate, LLC

In December 2011, the Company entered into a purchase agreement to acquire a vacant facility located in Las Vegas, Nevada for a purchase price of $4.8 million in order to relocate and expand the Company’s current client service capacity. Pursuant to the purchase agreement, initial total deposits of $0.5 million were paid in 2011, an additional $0.8 million in cash was paid at closing in 2012 and the remaining $3.5 million was funded by seller financing. In January 2012, the Company assigned its rights to the purchase agreement to Concorde Real Estate, LLC (“Concorde Real Estate”). The Company’s CEO, President and CFO at that time collectively owned approximately 51% of the membership interests of Concorde Real Estate, with the remainder of the membership interests represented by holders of preferred membership interests. The Company was repaid the deposits by Concorde Real Estate at the closing in 2012. As of December 31, 2013, the Company had no equity interest in Concorde Real Estate.

On June 27, 2012, Concorde Real Estate refinanced the original seller financing with a note payable to a financial institution. In connection with this financing arrangement, the Company guaranteed the debt of Concorde Real Estate. Based on the Company’s guarantee of Concorde Real Estate’s debt and its ability to direct the activities that most significantly impact the economic performance of Concorde Real Estate, the Company has determined that Concorde Real Estate is a VIE and that the Company is the primary beneficiary. Accordingly, the Company began consolidating Concorde Real Estate as of June 27, 2012.

The Company, through a wholly owned subsidiary, Concorde Treatment Center, LLC (“Concorde Treatment”), entered into a triple net operating lease with Concorde Real Estate. The lease commenced on November 1, 2012 and has a term of six years with three options to renew the lease for five years each. Payments under the lease are $0.2 million per month for the first year and increase annually on January 1 based on the annual change in the Consumer Price Index. Because Concorde Real Estate is a consolidated VIE, the rental payments since June 27, 2012 between the Company and Concorde Real Estate are eliminated in the Company’s consolidated financial statements.

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

The initial consolidation of Concorde Real Estate was accounted for as a business combination. The Company recorded the amounts that are associated with Concorde Real Estate’s interests in the VIE based upon the fair values of the assets and liabilities as follows as of June 27, 2012 (in thousands):

 

Property and equipment, net

   $ 7,720   

Other receivables

     40   
  

 

 

 

Total assets consolidated

   $ 7,760   
  

 

 

 

Notes payable

   $ 3,500   

Noncontrolling interest equity

     4,260   
  

 

 

 

Total liabilities and noncontrolling interest consolidated

   $ 7,760   
  

 

 

 

On June 12, 2013, Concorde Real Estate redeemed all of the outstanding preferred membership interests for $3.0 million in cash. Concorde Real Estate made periodic distributions to its members from cash available for distribution.

Consolidation of Behavioral Healthcare Realty, LLC

On October 8, 2013, the Company’s CEO, President and CFO formed Behavioral Healthcare Realty, LLC (“BHR”) and acquired all the membership interests in Concorde Real Estate (a VIE the Company has consolidated since June 27, 2012), and all the membership interests in Greenhouse Real Estate, LLC (“Greenhouse Real Estate”). Prior to being acquired by BHR, Greenhouse Real Estate was owned by the Company’s CEO, President and CFO.

Greenhouse Real Estate owns the real estate that is leased to one of the Company’s treatment facilities as discussed below. In connection with the formation of BHR, Greenhouse Real Estate obtained a $13.2 million credit facility from a bank that is guaranteed by the Company and its CEO and President. Based on the Company’s guarantee of BHR’s debt and its ability to direct the activities that most significantly impact the economic performance of BHR, the Company has determined that BHR is a VIE and that the Company is the primary beneficiary. Accordingly, the Company began consolidating BHR, which resulted in Greenhouse Real Estate being included in the Company’s consolidated financial statements, as of October 8, 2013. As of December 31, 2013, the Company has no equity interest in BHR.

In May 2013, the Company, through a wholly owned subsidiary, The Academy Real Estate, LLC (“Academy Real Estate”), acquired a property located in Riverview, Florida (just outside of Tampa, Florida) for a purchase price of $5.8 million. The Company was renovating this property and planned on converting it into a treatment facility. The Company funded the purchase price with $1.6 million from cash on hand and $3.6 million in proceeds from a new bank loan with an existing lender. In addition, a $0.6 million deposit was paid on behalf of the Company by Greenhouse Real Estate in March 2013 and was reimbursed to Greenhouse Real Estate by the Company in the third quarter of 2013. The Company spent $0.6 million on renovations from May 2013 through December 9, 2013 and capitalized $72,000 of interest related to this construction.

On December 10, 2013, the Company sold its membership interest in Academy Real Estate to BHR for $3.1 million plus the assumption of outstanding debt totaling $3.6 million which the Company has guaranteed. The Company received $0.8 million in cash and a promissory note receivable totaling $2.3 million. No gain or loss was recognized as a result of the transaction. Based on the Company’s guarantee of Academy Real Estate’s debt and its ability to direct the activities that most significantly impact the economic performance of Academy Real Estate, the Company has determined that it is a VIE and that the Company is the primary beneficiary. The

 

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assets and liabilities of Academy Real Estate and the results of its operations were consolidated on December 10, 2013, and thus the results of Academy Real Estate have been included in the consolidated financial statements since its acquisition in May 2013. The sale of Academy Real Estate to BHR and the consolidation of Academy Real Estate immediately after the sale had no effect on the Company’s cash flows after eliminating intercompany transactions.

BHR made periodic distributions to its members from cash available for distribution during the year ended December 31, 2013.

Professional Groups

During 2013, the Company managed the Professional Groups. These Professional Groups employ physicians that treat the Company’s clients and bill the payor for their services. The Company provides management and administrative services to the Professional Groups in return for a management fee. The Company also provided the initial working capital to each Professional Group and in return recorded accounts receivable from the Professional Groups and will continue to provide additional funding required for operating purposes. The Professional Groups were formed at various dates in 2012 and 2013. As of December 31, 2013, three of the five Professional Groups are owned by the Company’s CEO. The remaining Professional Groups are 100% owned by a physician who is employed by the Company. Based on the Company’s ability to direct the activities that most significantly impact the economic performance of the Professional Groups, provide necessary funding and the obligation and likelihood of absorbing all expected gains and losses, the Company has determined that each of the Professional Groups is a VIE and the Company is the primary beneficiary. Although the Company was the primary beneficiary of the Professional Groups from their respective dates of formation, the Company did not consolidate the Professional Groups until October 1, 2013 because the results of operations prior to that date were not material.

The initial consolidations of the assets and liabilities of Greenhouse Real Estate and the Professional Groups were accounted for as business combinations. The initial consolidation of Academy Real Estate was accounted for as an asset purchase as Academy Real Estate’s assets are held for development and Academy Real Estate does not have any operations. The Company recorded the amounts that are associated with Greenhouse Real Estate, the Professional Groups and Academy Real Estate interests in the VIEs based upon the fair values of the assets and liabilities on the respective dates of the transactions as follows (in thousands):

 

     Greenhouse
Real Estate
as of
October 8,
2013
     Professional
Groups as of
October 1,
2013
     Academy Real
Estate as of
December 10,
2013
     Total  

Cash

   $ 71       $ 139       $       $ 210   

Accounts receivable

             62                 62   

Prepaids and other current assets

     218                         218   

Property and equipment, net

     10,400                 6,708         17,108   

Other assets

     19                         19   
  

 

 

    

 

 

    

 

 

    

 

 

 

Total assets consolidated

     10,708         201         6,708         17,617   
  

 

 

    

 

 

    

 

 

    

 

 

 

Notes payable

     7,734                 6,708         14,442   

Accounts payable

     104         51                 155   

Noncontrolling interest equity

     2,870         150                 3,020   
  

 

 

    

 

 

    

 

 

    

 

 

 

Total liabilities and noncontrolling interest consolidated

   $ 10,708       $ 201       $ 6,708       $ 17,617   
  

 

 

    

 

 

    

 

 

    

 

 

 

 

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The results of operations for Concorde Real Estate from the consolidation date of June 27, 2012 are included in the consolidated statement of income for the year ended December 31, 2012 and include no revenues and loss before income taxes of $0.7 million. The results of operations for Greenhouse Real Estate from the consolidation date of October 8, 2013 are included in the consolidated statement of income for the year ended December 31, 2013 and include no revenues and loss before income taxes of $0.3 million. The results of operations for Academy Real Estate have been included in the consolidated statement of operations since the Company acquired the Riverview, Florida property in May 2013 and include no revenues or income before income taxes. The revenues of Concorde Real Estate and Greenhouse Real Estate consist of rental income from the Company and are eliminated in consolidation. The following table presents the unaudited pro forma revenues and income before income taxes had Concorde Real Estate Greenhouse Real Estate, Academy Real Estate and the Professional Groups been consolidated as of January 1, 2012 (in thousands):

 

     Revenues      Income before
income taxes
 

Combined pro forma from January 1, 2012 – December 31, 2012

   $ 66,035       $ 2,393   

Combined pro forma from January 1, 2013 – December 31, 2013

     115,712         2,548   

6. Notes Receivable – Related Party

The Company has a note receivable from the Company’s President that totaled $250,000 and $250,000 as of December 31, 2012 and 2013, respectively. The note is non-interest bearing and there are no payment terms or a maturity date associated with this note. Accordingly, this note receivable is classified as noncurrent in the consolidated balance sheet. The outstanding balance was repaid in full in April 2014 in connection with the acquisition of Behavioral Healthcare Realty, LLC by AAC Holdings, Inc. The Company also had a note receivable from the Company’s CEO that totaled $50,000 at December 31, 2012. This note was repaid in full in 2013.

7. Property and Equipment, net

Property and equipment consisted of the following at December 31, 2012 and 2013 (in thousands):

 

     2012     2013  

Computer equipment and software

   $ 1,268      $ 2,267   

Furniture and fixtures

     5,587        4,212   

Vehicles

     819        835   

Equipment under capital leases

            1,163   

Leasehold improvements

     1,520        3,099   

Construction in progress

     8        8,718   

Buildings

     6,908        17,918   

Land

     743        2,538   
  

 

 

   

 

 

 

Total property and equipment

     16,853        40,750   

Less accumulated depreciation and amortization

     (1,526     (3,742
  

 

 

   

 

 

 

Net property and equipment

   $ 15,327      $ 37,008   
  

 

 

   

 

 

 

Depreciation and amortization expense for the years ended December 31, 2012 and 2013 was $1.1 million and $2.5 million, respectively.

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

8. Goodwill and Intangible Assets

Changes to goodwill during 2012 and 2013 were as follows (in thousands):

 

Balance at December 31, 2011

   $ 2,327   

TSN Acquisition (see Note 5)

     8,536   
  

 

 

 

Balance at December 31, 2012

     10,863   

2013 activity

       
  

 

 

 

Balance at December 31, 2013

   $ 10,863   
  

 

 

 

Other identifiable intangible assets and related accumulated amortization consisted of the following as of December 31, 2012 and 2013 (in thousands):

 

     Gross Carrying
Amount
     Accumulated
Amortization
 
     December 31,      December 31,  
     2012      2013      2012      2013  

Trademarks and marketing intangibles

   $ 2,682       $ 2,682       $ 89       $ 358   

Non-compete agreements

     1,257         1,257         84         335   

Other

     51         271                 21   
  

 

 

    

 

 

    

 

 

    

 

 

 
   $ 3,990       $ 4,210       $ 173       $ 714   
  

 

 

    

 

 

    

 

 

    

 

 

 

Changes to the carrying value of identifiable intangible assets during 2012 and 2013 were as follows (in thousands):

 

Balance at December 31, 2011

   $   

TSN Acquisition (See Note 5)

     3,939   

Amortization expense

     (173

Other additions

     51   
  

 

 

 

Balance at December 31, 2012

     3,817   

Amortization expense

     (541

Other additions

     220   
  

 

 

 

Balance at December 31, 2013

   $ 3,496   
  

 

 

 

The weighted-average amortization periods of the acquired intangible assets are as follows:

 

     Weighted-Average
Amortization
Period (in Years)
 

Trademarks and marketing intangibles

     10   

Non-compete agreements

     5   

Other

     10   

 

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At December 31, 2013, all intangible assets are amortized using a straight-line method. Amortization expense expected to be recognized during fiscal years subsequent to December 31, 2013 is as follows (in thousands):

 

Year ended December 31,

      

2014

   $ 547   

2015

     547   

2016

     547   

2017

     463   

2018

     295   

Thereafter

     1,097   
  

 

 

 

Total

   $ 3,496   
  

 

 

 

9. Debt

A summary of the Company’s debt obligations, net of unamortized discounts, is as follows (in thousands):

 

     December 31,  
     2012     2013  

Non-related party debt:

    

Revolving line of credit

   $ 6,699      $ 12,550   

Variable interest entity debt

     7,381        21,548   

Acquisition-related debt

     1,500        1,500   

Asset purchases

     777        1,203   

Subordinated debt

     657        682   

Capital lease obligations

            1,022   
  

 

 

   

 

 

 

Total non-related party debt

     17,014        38,505   

Less current portion

     (8,674     (15,164
  

 

 

   

 

 

 

Total non-related party debt, long-term

   $ 8,340      $ 23,341   
  

 

 

   

 

 

 

Related party debt:

    

Acquisition-related debt

   $ 6,141      $ 4,389   

Subordinated debt

     175        181   

Share repurchases

     1,892          
  

 

 

   

 

 

 

Total related party debt

     8,208        4,570   

Less current portion

     (3,104     (795
  

 

 

   

 

 

 

Total related party debt, long-term

   $ 5,104      $ 3,775   
  

 

 

   

 

 

 

Revolving Line of Credit

In August 2011, the Company entered into a revolving line of credit (the “Revolving Line”) with a financial institution expiring on August 15, 2013 that permitted borrowings up to $4.5 million, subject to certain restrictions. The Revolving Line bore interest of the sum of one-month LIBOR plus 3.15% per annum. In March 2012, the borrowing limit was increased from $4.5 million to $10.0 million.

During the second quarter of 2013, the Revolving Line was amended to extend the maturity date to April 1, 2015 and to increase the maximum borrowing limit to the lesser of (i) $20.0 million or (ii) 70% of the Company’s eligible accounts receivable, subject to adjustment if the aggregate of all returns, rebates, discounts,

 

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credits and allowances for the immediately preceding three months is less than 15% of the Company’s gross revenues for such period. The amended Revolving Line bears interest at one-month LIBOR, as defined in the agreement, plus 2.5% per annum (2.75% as of December 31, 2013). Interest is payable monthly and is calculated on a 360 day year.

In August 2013, the Company amended the Revolving Line’s borrowing base to permit borrowings up to the lesser of (i) $20.0 million or (ii) 80% of the Company’s eligible accounts receivable at any time prior to February 1, 2014, and 70% of the Company’s eligible accounts receivable at any time on or after February 1, 2014, subject to adjustment if the aggregate of all returns, rebates, discounts, credits and allowances for the immediately preceding three months is less than 8% of the Company’s gross revenues for such period. The Revolving Line is secured by the Company’s accounts receivable, deposit accounts and other rights to payment, inventory, and equipment, and is guaranteed jointly and severally by all of the Company’s subsidiaries that have significant operations and/or assets and the Company’s CEO and President. The outstanding balance under the Revolving Line was $6.7 million at December 31, 2012 and $12.6 million at December 31, 2013. The maximum unused available credit under the amended Revolving Line as of December 31, 2013 was $2.2 million based upon borrowing base restrictions.

The Revolving Line, as amended, requires the Company to maintain a tangible net worth ratio not greater than 2.50 to 1.00, a fixed charge coverage ratio not less than 1.25 to 1.00, and net income of at least $1.00, all determined as of each quarter end. The Revolving Line limits capital expenditures to $0.1 million in each fiscal year unless approved by the financial institution, limits additional borrowing to $50,000 during the term of the agreement unless approved by the financial institution, limits operating lease expense to $0.1 million in each fiscal year and prohibits the payment of dividends in cash or stock. The Revolving Line also contains a cross-default clause linking a default under the Revolving Line to the occurrence of a default by the Company under any other debt agreement, material lease commitment, contract, instrument or obligation.

The Company was not in compliance with certain financial covenants contained in the Revolving Line at the end of each quarter in 2012 and 2013, including as of December 31, 2012 and 2013, which created a cross-default with the Greenhouse Real Estate, Concorde Real Estate and Academy Real Estate debt agreements with the same lender, but for which the Company obtained waivers. The Company obtained a waiver for the covenant defaults for 2012. Additionally, the Company’s expenditures for capital expenditures, total operating leases and the incurring of additional indebtedness exceeded the limits specified in the Revolving Line for the year ended December 31, 2013. For the quarter ended March 31, 2014, the Company was not in compliance with the covenants regarding capital expenditures and additional indebtedness.

On April 15, 2014, the Revolving Line was amended and restated and included a waiver for the noncompliance of the financial covenants and negative covenants described in the preceding paragraph. The amended and restated revolving line contains new covenants that were negotiated in consideration of the Company’s operating budget over the term of the amended and restated revolving line. The amendment decreased the maximum borrowing limit to the lesser of (i) $15.0 million or (ii) 70% of the Company’s eligible accounts receivable, and also modified the borrowing base contingency, interest rate, certain covenants and limits for capital expenditures and additional debt. This amended and restated credit facility is discussed in more detail in Note 18.

Variable Interest Entity Debt

In conjunction with the consolidation of Concorde Real Estate in 2012 and the remaining BHR VIEs that were consolidated in 2013 (see Note 5), the Company’s variable interest entity debt totaled $7.4 million at December 31, 2012 and $21.6 million at December 31, 2013. The terms of the debt are discussed below.

 

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Concorde Real Estate

In conjunction with the consolidation of Concorde Real Estate on June 27, 2012, the Company assumed a $3.5 million promissory note which was refinanced in July 2012 and replaced with loans totaling $7.4 million in two tranches. The first tranche totaled $4.4 million and bore interest at 3.0% plus one-month LIBOR, with interest payable monthly, and required a lump sum principal payment in July 2013. The amount outstanding under the first tranche was $4.4 million at December 31, 2012. The second tranche totaled $3.0 million, bore interest at 2.0% plus the lender’s prime rate (3.25% at December 31, 2012), with interest payable monthly, and required a lump sum principal payment in July 2013. The amount outstanding under the second tranche was $3.0 million at December 31, 2012. The additional debt in 2012 resulted from borrowings to complete the renovation of the Desert Hope facility.

In May 2013, Concorde Real Estate refinanced these two outstanding loans with a $9.6 million note payable that matures on May 15, 2018. The additional debt in 2013 was used to redeem the preferred membership interests in Concorde Real Estate. The note requires monthly principal payments of $53,228 plus interest and a balloon payment of $6.6 million due at maturity. Interest is calculated based on a 360 day year and accrues at the Company’s option of either (i) one-month LIBOR (as defined in the agreement) plus 2.5%, with such rate fixed until the next monthly reset date, or (ii) floating at one-month LIBOR (as defined in the agreement) plus 2.5%. In the event that the Company elects the floating option for either two consecutive periods or a total of three periods, the floating rate increases by 0.25%. The interest rate at December 31, 2013 was 2.75%, and the amount outstanding at December 31, 2013 was $9.3 million.

The note is guaranteed by the Company and its CEO and President and is secured by a deed of trust and the assignment of certain leases and rents. The note contains financial covenants that require the Company to maintain a fixed charge coverage ratio of not less than 1.25 to 1.00. The note also contains a cross-default clause linking a default under the note to the occurrence of a default by any guarantor or an affiliate of a guarantor with respect to any other indebtedness.

Greenhouse Real Estate

Greenhouse Real Estate (the “Borrower”) entered into a $13.2 million construction loan facility (the “Construction Facility”) with a financial institution on October 8, 2013 to refinance existing debt related to a 70-bed facility and to fund the construction of an additional 60 beds at this facility located in Grand Prairie, Texas. Monthly draws may be made against the Construction Facility based on actual construction costs incurred. Interest, which is payable monthly, is calculated based on a 360 day year and accrues at the Company’s option of either (i) one-month LIBOR (as defined in the agreement) plus 3.0%, with such rate fixed until the next monthly reset date, or (ii) floating at one-month LIBOR (as defined in the agreement) plus 3.0%. In the event that the Company elects the floating option for either two consecutive periods or a total of three periods, the floating rate increases by 0.25%. At December 31, 2013 the outstanding Construction Facility was $8.7 million and the interest rate was 3.25%. The Construction Facility matures on October 31, 2014. The Company capitalized interest totaling $3,000 related to this Construction Facility during 2013.

At the Borrower’s option, the Construction Facility can be converted to a permanent term loan with an extended maturity of October 31, 2019 provided (i) there is no default, (ii) the construction is 100% complete, (iii) there shall have occurred no material adverse change, as determined by the financial institution in its sole discretion, in the financial condition of the Borrower and (iv) other terms and conditions are satisfied. The maximum amount that may be converted is 65% of the appraised value at the time of the conversion. If at the time of the conversion the loan value exceeds the 65% loan-to-value ratio, the Borrower is permitted to make principal payments to reduce the loan-to-value to the 65% threshold. In the event the Borrower does not elect to or is unable to convert the Construction Facility to a permanent term loan the Borrower is required to pay an exit

 

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fee equal to 3.0% of the then outstanding balance. Principal payments at the time of the conversion are to be calculated based on a 15-year amortization schedule, and monthly principal and interest payments are required with a balloon payment at maturity. The permanent loan will bear interest at one-month LIBOR (as defined in the agreement) plus 2.5%, with such rate fixed for that monthly interest period. The Company intends to convert the Construction Facility to a permanent loan upon completion of construction as permitted in the agreement. Because the permanent loan contains contingencies other than the completion of the construction, the Company has classified the entire $8.7 million outstanding balance at December 31, 2013 as current.

The Construction Facility is secured by a deed of trust and the assignment of certain leases and rents and is guaranteed by the Company and two of BHR’s members who are also the CEO and President of the Company. The Borrower is required to maintain a minimum debt service coverage ratio of 1.25 to 1.00. The note also contains a cross-default clause linking a default under the Greenhouse Real Estate loan to the occurrence of a default by any guarantor or an affiliate of a guarantor with respect to any other indebtedness.

Academy Real Estate

In May 2013, the Company, through Academy Real Estate, obtained a $3.6 million note payable from a financial institution to fund a portion of the acquisition of the property located in Riverview, Florida (just outside of Tampa, Florida). The note payable matured on November 10, 2013 and was renewed under identical terms. As discussed in Note 5, in connection with the Company’s sale to BHR of its membership interests of Academy Real Estate on December 10, 2013, BHR assumed the $3.6 million note payable. Interest, which is payable monthly, is calculated based on a 360 day year and accrues at the Company’s option of either (i) one-month LIBOR (as defined in the agreement) plus 3.0%, with such rate fixed until the next monthly reset date or (ii) floating at one-month LIBOR (as defined in the agreement) plus 3.0%. In the event that the Company elects the floating option for either two consecutive periods or a total of three periods, the floating rate increases by 0.25%. The interest rate at December 31, 2013 was 3.165%. The note matured on February 10, 2014 and was renewed under the same terms described above, with an extended maturity date of July 14, 2014. The agreement requires the Company to maintain a minimum fixed charge coverage ratio of 1.25 to 1.00 and contains other restrictive financial covenants. The agreement also contains a cross-default clause linking a default under the Academy Real Estate note to the occurrence of a default by any guarantor or an affiliate of a guarantor with respect to any other indebtedness.

At December 31, 2013, the Company was in compliance with the financial covenants of the BHR debt. The instances of noncompliance under the Revolving Line created a cross-default with the Greenhouse Loan, the Concorde Loan and the Academy Loan. The Company obtained a waiver for the covenant defaults under the Revolving Line for 2012, and the amendment and restatement of our prior credit facility in April 2014 included a waiver for the noncompliance of the financial covenants and negative covenants that occurred under the Revolving Line in 2013 and the quarter ended March 31, 2014. We also obtained waivers for the cross-defaults under the Construction Facility, the Concorde Real Estate note payable and the Academy Real Estate note payable.

Acquisition Related Debt

TSN Acquisition – Related Party

The Company financed a portion of the TSN Acquisition consummated on August 31, 2012 with the following sources of debt. The Company entered into a $6.2 million subordinated note payable with the TSN Sellers. Under the terms of the agreement, the note is separated into the following tranches: (i) $2.2 million paid in equal monthly principal installments over 36 months, bearing interest at 5% per annum, (ii) $2.5 million due on August 31, 2015 (the “Balloon Payment”), bearing interest at 3.125% per annum and (iii) a contingent balloon payment of up to $1.5 million due on August 31, 2015 (the “Contingent Payment”), bearing interest at 3.125% per annum. The Contingent Payment is contingent on the achievement of certain performance metrics

 

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over the term of the note. Due to the contingent nature of the Contingent Payment, a discount of approximately 13% was applied to the Contingent Payment to reflect the weighted-average probability the Contingent Payment would not be made. In April 2013, $0.5 million outstanding under the Balloon Payment was converted into 60,753 shares of the Company’s common stock at a conversion price of $8.23 per share. The Company estimates the fair value of the Contingent Payment each reporting period through an analysis of the TSN Sellers’ estimated achievement of the performance metrics specified in the agreement. Based upon this analysis, the Company determined a claw back of $0.5 million of the Contingent Payment exists at December 31, 2013 and, accordingly, has adjusted the outstanding balance of the Balloon Payment to $3.0 million at that date. In addition to the claw back on the Contingent Payment, the Company has included a reduction of 75,472 shares of common stock in the computation of its earnings per share for the year ended December 31, 2013 to reflect the claw back of those shares based upon this analysis. As of December 31, 2012 and 2013, the outstanding balance related to the seller subordinated notes payable was $5.8 million and $4.3 million, respectively.

The Company also entered into a $0.6 million subordinated promissory note with one of the TSN Sellers that matured on March 1, 2013. At December 31, 2012, the outstanding balance was $0.3 million. The note bore interest at 3.125% per annum and required monthly principal and interest payments of $0.1 million. The note was fully repaid in March 2013.

TSN Acquisition – Non-Related Party

The Company also entered into an agreement with a financial institution to borrow $2.5 million to fund a portion of the TSN Acquisition that matures on July 1, 2014. The note bears interest, which is payable monthly, at 5.0% plus one-month LIBOR (5.25% at December 31, 2013) and requires a lump sum payment on July 1, 2014. The agreement contains certain restrictive financial covenants, including a maximum ratio of total liabilities to tangible net worth. The Company prepaid $1.0 million in 2012. As of December 31, 2012 and 2013, the outstanding balance was $1.5 million.

Other

In connection with an acquisition in 2011, the Company entered into separate notes payable with the former owners. Under the terms of the agreement, the notes bear interest at 12% per annum, with interest payable monthly. The notes mature in November 2014. As of December 31, 2012 and 2013, the outstanding balance was $50,000.

Asset Purchases

The Company has various notes payable with third-party creditors primarily for the purchase of vehicles, furniture, and office equipment. The notes have maturity dates ranging from March 2014 to November 2017, with terms ranging from 36 to 72 months and interest rates ranging from 0.0% to 12.3% per annum. Monthly payments range from $200 to $4,600. As of December 31, 2012 and 2013, aggregate balances on these notes were $0.8 million and $0.5 million, respectively.

In June 2013 the Company borrowed $0.8 million from an existing lender to fund the purchase of equipment. The note bears interest, which is payable monthly, at one-month LIBOR plus 3.15% (which was 3.4% at December 31, 2013) and requires monthly principal payments of $16,250 commencing June 15, 2013, with final installment of unpaid principal due on May 15, 2017. At December 31, 2013, the outstanding balance was $0.7 million.

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

Other – Related Party

In November 2012, the Company received proceeds from a $1.5 million subordinated debt agreement with the Company’s CEO. The note bore interest at 12% per annum, with a lump sum payment due in November 2013. As of December 31, 2012, the outstanding balance was $1.5 million. In April 2013, the entire balance of this subordinated debt was converted into 182,260 shares of common stock at a conversion price of $8.23 per share, which management estimated to be fair value.

On April 28, 2011, the Company entered into an agreement with a former officer and stockholder of the Company for the repurchase of common and preferred shares held by the stockholder. Under the terms of the agreement, the Company issued a $0.6 million subordinated note payable and guaranteed other payments totaling $0.2 million to the stockholder. The outstanding balance of the note payable and guaranteed other payments at December 31, 2012 was $0.4 million, net of imputed interest. The balance of the note payable and the guaranteed other payments was fully paid in the second quarter of 2013.

Subordinated Debt Issued with Detachable Warrants (Related Party and Non-related Party)

In March and April 2012 the Company issued $1.0 million of subordinated promissory notes, of which $0.2 million was issued to a director of the Company. The notes bear interest at 12% per annum. The notes mature at various dates throughout 2015 and 2017. Interest is payable monthly and the principal amount is due, in full, on the applicable maturity date of the note. In connection with the issuance of these notes, the Company issued detachable warrants to the lenders to purchase a total of 71,705 shares of common stock at $1.00 per share. The warrants are exercisable at any time up to their expiration on March 31, 2022. The Company recorded a debt discount of $0.1 million related to the warrants which reduced the carrying value of the subordinated notes. As of December 31, 2012, the outstanding balance of the notes, net of the unamortized debt discount of $0.1 million, was $0.8 million, of which $0.2 million was owed to a director of the Company. As of December 31, 2013, the outstanding balance of the notes, net of the unamortized debt discount of $83,000, was $0.9 million, of which $0.2 million was owed to a director of the Company.

The Company calculated the fair value of warrants issued with the subordinated notes using the Black-Scholes valuation method. The following assumptions were used to value the warrants: a stock price of $2.13, an exercise price of $1.00, expected life of 10 years, expected volatility of 20%, risk free interest rates ranging from 2.1% to 4.0% and no expected dividend yield. In March 2014, warrants representing the right to purchase 67,931 shares of common stock were exercised and a total of 67,931 shares of common stock were issued to the exercising warrant holders, including 15,095 shares to a Company director.

Capital Lease Obligations

In August 2013, the Company entered into a $0.5 million capital lease with a third party leasing company for lab equipment and office furniture. The capital lease bears interest at 5.1% per annum and requires 36 monthly payments of $13,667. At the end of the lease term the Company may buy the equipment for $1. The outstanding balance under this capital lease at December 31, 2013 was $0.4 million.

In November 2013, the Company entered into a $0.3 million capital lease with a third party leasing company for equipment. The capital lease requires 60 monthly payments of $5,366 and the annual interest rate is 5.1%. At the end of the lease term the Company may buy the equipment for $1. The outstanding balance under this capital lease was $0.3 million at December 31, 2013.

During 2013, the Company entered into various other capital leases with third party leasing companies totaling $0.4 million for laboratory and other equipment. These leases have terms ranging from 36 to 60 months, with maturity dates ranging from November 2015 to November 2018, and interest rates ranging from 4.0% to

 

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5.1% per annum. Monthly payments range from $300 to $2,700. As of December 31, 2013, the aggregate balance of these notes was $0.3 million.

As of December 31, 2013, total assets under capital leases, net of accumulated amortization, were $1.0 million. Total obligations under capital leases at December 31, 2013 were $1.0 million of which $0.3 million was included in the current portion of long-term debt. There were no capital lease obligations outstanding at December 31, 2012.

A summary of future maturities of long-term debt, as of December 31, 2013, is as follows (in thousands):

 

Years ending December 31,

   Non-
Related
Party
    Related
Party
    Capital
Lease
Obligations
    Total  

2014

   $ 14,892      $ 942      $ 338      $ 16,172   

2015

     13,749        3,719        338        17,806   

2016

     922        6        246        1,174   

2017

     1,280        181        123        1,584   

2018

     6,705               67        6,772   

Thereafter

                            
  

 

 

   

 

 

   

 

 

   

 

 

 

Total

     37,548        4,848        1,112        43,508   

Unamortized discount

     (65     (278            (343

Amounts representing interest

                   (90     (90
  

 

 

   

 

 

   

 

 

   

 

 

 

Total, net of unamortized discount and interest

   $ 37,483      $ 4,570      $ 1,022      $ 43,075   
  

 

 

   

 

 

   

 

 

   

 

 

 

10. Brand Promise Guarantee

The Company established a Brand Promise guarantee program in September 2012. Under this promise the Company guarantees recovery for clients who successfully complete 90 consecutive days of treatment. In the event of a relapse following treatment, the client may return for an additional 30 days of treatment free of charge. The Company provides a provision for estimated future guarantee costs based on the number of eligible clients, the expected number of clients that will seek additional treatment (based on industry data) and the estimated costs to provide treatment for the guarantee period.

The following table details the changes in the accrued guarantee balances (in thousands):

 

     For the Year ended
December 31,
 
     2012      2013  

Balance at beginning of year

   $       $   

Guarantee provision

             70   

Guarantee claims

             (10
  

 

 

    

 

 

 

Total

   $       $ 60   
  

 

 

    

 

 

 

11. Stockholders’ Equity and Mezzanine Equity

During 2013 the Company sold 906,439 shares of its common stock in an exempt offering at $8.23 per share, which the Company’s management estimated to be fair value. Included in the total shares issued were 455,651 shares sold to directors of the Company and 3,038 shares sold to each of the CFO, Chief Operating Officer (“COO”) and the Vice President of Marketing. The Company issued 852,137 of these shares in March 2013

 

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and 54,302 in April 2013. Additionally, 182,260 shares were issued to the Company’s CEO upon conversion of $1.5 million in subordinated debt and 60,753 shares were issued to a Vice President of the Company upon conversion of $0.5 million under the Balloon Payment issued by the Company (see Note 9).

In connection with the exempt offering described above, a Company employee subscribed for 12,150 shares of common stock at $8.23 per share, which the Company’s management estimated to be fair value. As consideration for the shares, the employee issued to the Company a subscription note receivable in the amount of $0.1 million. The Company is forgiving this subscription note receivable over a 12-month period ending on July 1, 2014. During 2013 the Company recorded $42,000 in compensation expense and additional paid-in capital related to this forgiveness.

In April 2013, the Company redeemed 444,434 shares of common stock from one of the TSN Sellers at $8.23 per share, which the Company’s management estimated to be fair value, for an aggregate purchase price of $3.7 million.

Mezzanine Equity

Share Imperfections

In 2008 preferred shares were issued by the Company’s previous board of directors prior to the timely filing of a Certificate of Designation with the Secretary of State of Nevada. Additionally, in 2008 certain common shares were issued by the previous board of directors of the Company that were in excess of the number of shares duly authorized by the Company’s Articles of Incorporation. The Company has classified these preferred and common shares as mezzanine equity at the original purchase price in the consolidated balance sheets because they do not meet the definition of permanent equity as a result of these legal imperfections.

To address these issues, AAC Holdings, Inc., a newly formed Nevada corporation (“Holdings”), conducted a voluntary private share exchange with certain stockholders of AAC, whereby holders representing 93.4% of the outstanding shares of common stock of AAC, that was classified in both Mezzanine Equity and Stockholders’ Equity, exchanged their shares on a one-for-one basis for shares of Holdings common stock (the “Private Share Exchange”). The Private Share Exchange was conditioned upon, among other things, a release by each exchanging stockholder of any and all potential claims arising from corporate actions that were not conducted in compliance with Nevada law. The Private Share Exchange was completed in the second quarter of 2014 (see Note 18).

Statement of Mezzanine Equity

Changes to mezzanine amounts during 2012 and 2013 were as follows (dollars in thousands):

 

         Noncontrolling Interest          American Addiction Centers, Inc.  
     Series A Preferred      Series B Preferred     Common Shares  
     Units      Amount      Shares     Amount     Shares     Amount  

Balance at December 31, 2011

           $         10,000      $ 1,000        7,452,523      $ 10,613   

2012 activity

                                            
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Balance at December 31, 2012

                     10,000        1,000        7,452,523        10,613   
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Stock buy-back

                     (10,000     (1,000     (171,240     (171

Issuance of preferred stock

     28         1,400                                
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

Balance at December 31, 2013

     28       $ 1,400              $        7,281,283      $ 10,442   
  

 

 

    

 

 

    

 

 

   

 

 

   

 

 

   

 

 

 

In April 2013, the Company redeemed 171,240 common shares from the Company’s President at $8.23 per share, which the Company’s management estimated to be fair value, for an aggregate purchase price of $1.4

 

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million. The redemption of these shares is reflected as a reduction to mezzanine equity at its carrying value, with the $1.3 million gain on the redemption of the shares reflected as a reduction in additional paid-in capital.

AAC Series B Preferred Stock

The Series B Preferred Stock (“Series B”) had no conversion or annual dividend rights; however, the Series B would participate in dividends in the same manner and amount of any dividend issued to common stockholders. The Series B had voting rights equal to 100 votes per share of Series B and voted together with common stockholders. The Series B had a liquidation value of $100 per share. As of December 31, 2012, the Company had 14,000 authorized shares of Series B. In the first quarter of 2013, the Company’s Board of Directors eliminated the Series B and all outstanding shares were repurchased for a de minimis amount.

BHR Series A Preferred (Variable Interest Entity)

In October 2013, BHR amended its limited liability company agreement to permit the issuance of Series A Preferred Units. In the fourth quarter of 2013, BHR received proceeds of $1.4 million from the sale of 28 Series A Preferred Units valued at $50,000 per unit. An entity controlled by the spouse of one of the Company’s directors purchased $200,000 of the Series A Preferred Units. The unit holders are entitled to receive a 12% per annum preferred return on their initial investment, payable quarterly in arrears, have no equity appreciation ability and limited voting rights that are conditioned upon BHR’s default on the distribution of the 12% preferred return. The Series A Preferred Units contain certain embedded issuer call and holder put provisions. BHR has the option to call and redeem all or any portion of the Series A Preferred Units for $50,000 per unit plus any accrued and unpaid preferred return at any time after the twelfth month of issuance. The holders of the Series A Preferred Units have a put right during three periods discussed below, that, if exercised, requires BHR to redeem 100% of the issued and outstanding Series A Preferred Units by making a payment equal to $50,000 per unit plus the accrued but unpaid preferred return. The holder may exercise the put right on the 36th month, 48th month and 60th month following the date of issuance for a 30-day period. In the event of a sale of a property owned by BHR, the holders of the Series A Preferred Units are entitled to the repayment of their initial capital contribution plus any accrued and unpaid preferred return. The Company has classified the Series A Preferred Units as noncontrolling interest as a part of mezzanine equity because the potential redemption is not within the complete control of BHR until the last put option period has expired. All of the outstanding Series A Preferred Units were redeemed in April 2014 (see Note 18).

12. Stock-Based Compensation Plans

The Company adopted the 2007 Stock Incentive Plan (“Incentive Plan”) in 2007. An aggregate of 2,500,000 shares of common stock are reserved for issuance pursuant to the Incentive Plan. The Incentive Plan is administered by the Board of Directors, which determines, subject to the provisions of the Incentive Plan, the employees, directors or consultants to whom incentives are awarded. The Board of Directors may award (i) “incentive stock options” within the meaning of Section 422 of the Internal Revenue Code of 1986, (ii) “non-qualified stock options” (options which do not meet the requirements of Section 422), (iii) shares of “restricted stock”, (iv) stock grants and (v) “stock bonuses.” Subject to the terms of the Incentive Plan, the Board of Directors may also determine the prices, expiration dates and other material features of any incentive award. As of December 31, 2013, no stock options had been granted under the Incentive Plan and no options were outstanding.

In December 2012, the Company awarded 170,157 shares of its common stock, at a fair market value of $8.23 per share, which the Company’s management estimated to be fair value, to the CFO of the Company. The Company issued these shares in March 2013. As a result of the award, the Company recorded $1.4 million of compensation expense and $1.0 million of additional compensation expense to satisfy the employee’s personal tax obligation related to the vesting of the grant during the year ended December 31, 2012. On December 31,

 

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2012, the Company also awarded 85,078 of unvested common stock, at a fair market value of $8.23 per share, which the Company’s management estimated to be fair value, to this same executive. These shares vested ratably at the end of each quarter in 2013. During the year ended December 31, 2013, the Company recorded $0.7 million of compensation expense and $0.5 million of additional compensation expense to satisfy the employee’s tax obligation related to the vesting of the grant. Such expenses are included on the Company’s consolidated statements of income under the caption “salaries, wages and benefits.”

In determining the fair value of the Company’s common stock the Company reviewed an independent third party valuation report, which used a discounted cash flow method applying a discount rate of 17.6%. Other factors considered in the Company’s valuation were the TSN Acquisition in August 2012, which provided an indication of a recent value established as a result of negotiation between sophisticated parties with substantial due diligence about both parties and a market transaction announced in November 2012 involving similar behavioral health companies.

In November 2013 the Company issued a total of 92,815 shares of restricted common stock to its COO, Vice President of Business Development and Vice President of Marketing under the Incentive Plan, of which 23,203 shares vested on December 31, 2013, and the remaining 69,612 shares vest ratably at the end of each of the first three quarters in 2014. The fair value on the award date was $10.19 per share, which the Company’s management estimated to be fair value. As a result of the award, the Company recorded $0.2 million of compensation expense and $0.1 million of additional compensation expense to satisfy the employees’ personal tax obligations related to the vesting of the grant during the fourth quarter of 2013. Such expenses are included on the Company’s consolidated statements of income under the caption “salaries, wages and benefits.”

The valuation of the Company’s common stock for the November stock award was determined in accordance with the guidelines outlined in the American Institute of Certified Public Accounts Practice Aid, Calculation of Privately- Held Company Equity Securities Issues as Compensation . The Company engaged a third party valuation firm to construct a probability-weighted expected return model (“PWERM”) and to assist and advise management in determining the appropriate inputs and metrics to the model. Because there was no public market for the Company’s common stock, the board of directors, with input from management, exercised significant judgment and considered numerous objective and subjective factors to determine the fair value of the Company’s common stock as of the November 14, 2013, including the following factors:

 

    previous third party valuations of the Company’s common stock;

 

    the price of the Company’s common stock sold to third-party investors;

 

    the value of the Company’s common stock issued in the TSN Acquisition in August 2012;

 

    a market transaction announced in November 2012 involving similar behavioral health companies;

 

    the valuation of a comparable public company;

 

    the Company’s operating and financial performance;

 

    current business conditions and projections;

 

    the Company’s stage of development;

 

    the likelihood of achieving a liquidity event for the shares of the Company’s common stock; such as an initial public offering or sale of the Company, given prevailing market conditions; and

 

    any adjustment necessary to recognize a lack of marketability for common stock.

The Company used PWERM in determining the Company’s equity value for the November 2013 grant. PWERM is an analysis of future values of a company for several likely liquidity scenarios that may include a

 

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strategic sale or merger, an initial public offering or the dissolution of a company, as well as a company’s enterprise value assuming the absence of a liquidity event. For each possible future event, the future values of the company are estimated at certain points in time. This future value is then discounted to a present value using an appropriate risk-adjusted discount rate. Then, a probability is estimated for each possible event based on the facts and circumstances as of the valuation date. Using PWERM, the Company estimated the value of the Company’s common stock based upon an analysis of varying values for the Company’s common stock assuming (i) the completion of an initial public offering, (ii) a merger or acquisition and (iii) the continuation as a private company. The Company applied a percentage probability weighting to each of these scenarios based on the Company’s expectations of the likelihood of each event. Based on the foregoing PWERM analysis, the fair value of the November 19, 2013 grants of 92,815 shares of restricted common stock was determined to be $10.19 per share, as estimated by the Company’s management.

A summary of share activity under the Incentive Plan is set forth below:

 

     Shares     Weighted-
average Grant
Date Fair Value
 

Unvested at December 31, 2011

              

Granted

     255,235      $ 8.23   

Vested

     (170,157     8.23   
  

 

 

   

Unvested at December 31, 2012

     85,078        8.23   

Granted

     92,815        10.19   

Vested

     (108,281     8.65   
  

 

 

   

Unvested at December 31, 2013

     69,612      $ 10.19   
  

 

 

   

13. Restructuring Expenses

During the first half of 2013, the Company implemented restructuring plans to centralize its call centers and to close one of the facilities that was acquired in the TSN Acquisition. Restructuring and exit charges of $0.8 million were expensed in 2013 related to these restructuring activities.

Leading Edge, the New Jersey treatment facility that was acquired in the TSN Acquisition, was closed in June 2013. Management made the decision to exit the facility because the amenities and the service offerings at the facility were inconsistent with the Company’s long-term strategy. As a result of the facility closure, the Company recorded restructuring charges of $0.5 million, including payroll, severance and other employee related costs of $0.2 million and facility exit charges of $0.3 million. The facility exit costs include ongoing lease obligations directly related to closing the facility. We estimate that approximately $0.1 million of cash payments related to lease obligations will be made from 2014 through January 2017 as the related leases expire.

Restructuring expenses related to centralizing the call centers totaled $0.3 million in 2013, which included $0.1 million related to payroll, severance and other employee related costs associated with a headcount reduction of 22 employees, employee relocation costs of $0.1 million and $0.1 million of facility exit costs (net of $0.1 million in sublease income). The facility exit costs relate to an ongoing lease obligation. The Company estimates that approximately $0.2 million of total cash payments related to this obligation, excluding $0.1 million in sublease income on this lease, will be made from 2014 through October 2015 as the related lease expires. To determine the facility exit costs certain assumptions were made related to sublease rates and common area maintenance charges.

 

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The following table summarizes the restructuring liability (in thousands):

 

     Payroll,
Severance
and Other
Employee
Related
Costs
    Relocation
Costs
    Facility
Costs
    Total  

Leading Edge Facility Closure

        

January 1, 2013 Liability

   $      $      $      $   

Charges

     184               292        476   

Payments

     (184            (114     (298
  

 

 

   

 

 

   

 

 

   

 

 

 

December 31, 2013 Liability

   $      $      $ 178      $ 178   
  

 

 

   

 

 

   

 

 

   

 

 

 

Call Centers Consolidation

        

January 1, 2013 Liability

   $      $      $      $   

Charges

     90        113        127        330   

Payments

     (90     (113     (26     (229
  

 

 

   

 

 

   

 

 

   

 

 

 

December 31, 2013 Liability

   $      $      $ 101      $ 101   
  

 

 

   

 

 

   

 

 

   

 

 

 

Summary for Call Center and Leading Edge

        

January 1, 2013 Liability

   $      $      $      $   

Costs accrued

     274        113        419        806   

Cash payments

     (274     (113     (140     (527
  

 

 

   

 

 

   

 

 

   

 

 

 

December 31, 2013 Liability

   $      $      $ 279      $ 279   
  

 

 

   

 

 

   

 

 

   

 

 

 

The remaining restructuring liability at December 31, 2013 is classified in the consolidated balance sheet as accrued liabilities of $0.1 million and other long-term liabilities of $0.2 million.

14. Income Taxes

Income tax expense consisted of the following for the years ended December 31, 2012 and 2013 (in thousands):

 

     2012      2013  

Current:

     

Federal

   $ 879       $ 1,587   

State

     232         528   
  

 

 

    

 

 

 

Total current tax expense

     1,111         2,115   
  

 

 

    

 

 

 

Deferred:

     

Federal

     5         (675

State

     32         (825
  

 

 

    

 

 

 

Total deferred tax expense

     37         (1,500
  

 

 

    

 

 

 

Total income tax expense

   $ 1,148       $ 615   
  

 

 

    

 

 

 

 

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The Company’s effective income tax rate for the years ended December 31, 2012 and 2013 reconciles with the federal statutory rate as follows:

 

     2012     2013  

Federal statutory rate

     35.0     35.0

State income taxes, net of federal tax benefit

     6.7        4.4   

Non-deductible expenses

     4.2        8.1   

Change in valuation allowance

            4.1   

Uncertain tax positions

            2.8   

Other differences

     (1.6     0.4   
  

 

 

   

 

 

 

Effective income tax rate on income applicable to American Addiction Centers, Inc.

     44.3        54.8   

Loss (income) attributable to noncontrolling interest from consolidated VIEs

     6.8        (25.6
  

 

 

   

 

 

 

Effective income tax rate on income before income taxes

     51.1     29.2
  

 

 

   

 

 

 

The decrease in the Company’s effective tax rate for 2013 compared to 2012 resulted primarily from the impact of the VIEs included within the Company’s financial statements. The VIEs consist primarily of flow-through entities and are thus not taxable for federal income tax purposes.

Deferred income tax assets (liabilities) are comprised of the following at December 31, 2012 and 2013 (in thousands):

 

     2012     2013  

Accounts receivable

   $ 290      $   

Employee compensation

     198        540   

Operating loss carryforwards

     706        1,211   

Accrued litigation

            959   

Other

     133        142   

Valuation allowances

     (678     (989
  

 

 

   

 

 

 

Total deferred tax assets

     649        1,863   

Property, equipment and amortization

     (2,304     (2,480

Accounts receivable

     (1,498     (1,036
  

 

 

   

 

 

 

Total deferred tax liabilities

     (3,802     (3,516
  

 

 

   

 

 

 

Net deferred tax liabilities

   $ (3,153   $ (1,653
  

 

 

   

 

 

 

The balance sheet classification of deferred tax assets (liabilities) at December 31, 2012 and 2013 was as follows (in thousands):

 

     2012     2013  

Current

   $ 873      $ 676   

Long-term

     (4,026     (2,329
  

 

 

   

 

 

 

Total

   $ (3,153   $ (1,653
  

 

 

   

 

 

 

During 2013 the Company’s valuation allowance increased by $0.3 million to $1.0 million at December 31, 2013, as the Company determined that it was more likely than not that certain of its state operating loss carryforwards will not be realized.

 

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The statutes of limitations applicable for federal income tax purposes and for substantially all states with which the Company has a nexus have expired through 2009. However, the Company has net operating loss carryforwards from closed tax years which could be adjusted upon an audit. The Company has not been notified of any federal or state income tax examinations. As of December 31, 2012 and 2013, the Company has $0 and $0.1 million of uncertain tax positions, respectively. At December 31, 2013, the Company had $17.6 million in state net operating losses which expire at various dates beginning in 2027.

15. Fair Value of Financial Instruments

The carrying amounts reported at December 31, 2012 and 2013 for cash and cash equivalents, accounts receivable, prepaid expenses and other current assets, accounts payable and accrued liabilities approximate fair value because of the short-term maturity of these instruments and are categorized as Level 1 within the GAAP fair value hierarchy. The fair value of the Company’s revolving line of credit is categorized as Level 2. The carrying amount of the Company’s debt approximates fair value because interest rates approximate the current rates available to the Company.

The Company has debt with variable and fixed interest rates. The fair value of debt with fixed interest rates was determined using the quoted market prices of debt instruments with similar terms and maturities, which are considered Level 2 inputs. The fair value of debt with variable interest rates was also measured using Level 2 inputs, including good faith estimates of the market value for the particular debt instrument, which represent the amount an independent market participant would provide, based upon market observations and other factors relevant under the circumstances. The carrying value of such debt approximated its estimated fair value at December 31, 2012 and 2013.

Intangible assets are measured at fair value on a nonrecurring basis. These assets are classified in Level 3 of the fair value hierarchy. Goodwill and other indefinite-lived intangibles are tested for impairment at least annually, or more frequently if circumstances indicate that the carrying amount exceeds fair value.

The Company estimates the fair values of goodwill and other indefinite-lived intangibles utilizing multiple measurement techniques. The estimation is primarily determined based on an estimate of future cash flows (income approach) discounted at a market derived weighted-average cost of capital. The income approach has been determined to be the most representative of fair value because the Company’s equity does not have an active trading market. Other unobservable inputs used in these valuations include management’s cash flow projections and estimated terminal growth rates. The valuation of indefinite-lived intangible assets also includes an unobservable input for royalty rate, which is based on rates used by comparable industries.

The useful lives of definite-lived intangible assets (customer relationships) are evaluated whenever events or circumstances warrant a revision to the remaining amortization period. The fair value of definite-lived intangible assets is based on estimated cash flows from the future use of the asset, discounted at a market derived weighted-average cost of capital.

No impairment charges were recorded related to goodwill or other intangible assets for the years ended December 31, 2012 and 2013.

Long-lived assets are measured at fair value on a nonrecurring basis and are classified in Level 3 of the fair value hierarchy. The fair value is estimated utilizing unobservable inputs, including appraisals on real estate as well as evaluations of the marketability and potential relocation of other assets in similar condition and similar market areas. The Company analyzes long-lived assets on an annual basis for any triggering events that would necessitate an impairment test. No impairment charges were recorded in 2012 or 2013.

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

16. Commitments and Contingencies

Operating Leases

The Company has entered into various operating leases expiring through October 2018. Commercial properties under operating leases primarily include space required to perform client services and space for administrative facilities. Rent expense was $3.6 million and $4.6 million for the years ended December 31, 2012 and 2013, respectively. Included in such amounts were related party rent expenses totaling $1.2 million and $1.3 million for the years ended December 31, 2012 and 2013, respectively.

Concorde Real Estate

As discussed in Note 5, the Company, through Concorde Treatment Center, leased property under a triple net operating lease with Concorde Real Estate. Lease payments commenced in August 2012 and these rental payments have been eliminated in consolidation.

Greenhouse Real Estate

The Company leased a treatment facility from Greenhouse Real Estate. Certain of the Company’s common stockholders and the Company’s CEO, President and CFO collectively owned approximately 55% of Greenhouse Real Estate until 2013, at which time the Company’s CEO, President and CFO acquired all the outstanding membership interests of Greenhouse Real Estate. The initial lease was for a period of five years and the Company had an option to extend the lease for an additional five years.

On October 1, 2012, the Company executed an amendment to the lease agreement to provide for an increase in the rent payable by the Company from $90,000 per month to $135,000 per month. The Company further amended the lease on October 1, 2013 to provide for an annual adjustment to the base rent on January 1, based upon the difference in the Consumer Price Index from the prior year. As discussed in Note 5, on October 8, 2012 Greenhouse Real Estate was acquired by BHR, a consolidated VIE of the Company. Rental expense under the lease for 2012 was $1.2 million and was $1.3 million for the period from January 1, 2013 through October 8, 2013. The Greenhouse Real Estate lease transactions have been eliminated in consolidation since October 8, 2013.

The future minimum lease payments under non-cancelable operating leases (exclusive of leases with consolidated VIEs) with remaining terms of one or more years as of December 31, 2013 consisted of the following (in thousands):

 

Years ending December 31,

   Annual
Payments
 

2014

   $ 1,126   

2015

     809   

2016

     629   

2017

     192   

2018

     23   

Thereafter

       
  

 

 

 

Total

   $ 2,779   
  

 

 

 

The Company recognizes rent expense on a straight line basis with the difference between rent expense and rent paid recorded as deferred rent. Such amount is included in accrued liabilities in the accompanying consolidated balance sheets.

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

Litigation

In April 2013, two wage and hour claims were filed against the Company in the State of California and were subsequently consolidated into a class action. In June 2013 the parties agreed to settle the substantive claims for $2.6 million during mediation. Once the settlement became probable, the Company established a $2.6 million reserve during the second quarter of 2013 for this matter. Subsequently, on April 9, 2014 and following court approval, the Company settled this matter with payment of $2.6 million. The total amount of the litigation settlement of $2.6 million is reflected in accrued liabilities at December 31, 2013 and classified as litigation settlement in the consolidated statement of income for the year ended December 31, 2013.

American Addiction Centers, Inc. v. James D. Bevell, Jr.

On February 3, 2014, AAC filed an action against James D. Bevell in the U.S. District Court in the Middle District of Tennessee, alleging breach of contract and tortious interference with business practices arising out of Mr. Bevell’s breach of his non-compete agreements. Mr. Bevell is the former Chief Innovation Officer of AAC and owns 4.5% of the outstanding common stock of AAC as of April 15, 2014. AAC’s complaint seeks preliminary and permanent injunctive relief, declaratory judgment, compensatory damages, punitive damages for intentional, fraudulent, reckless or grossly negligent conduct, reasonable attorneys’ fees and costs and such other legal, equitable or general relief for the breach of contract and associated wrongs. On March 5, 2014, the court granted a preliminary injunction enjoining Mr. Bevell and his officers, agents, servants, employees, attorneys and all persons in active concert or participation with him from violating the non-competition and non-solicitation provisions contained in his employment agreement with AAC and in the purchase agreement related to the TSN Acquisition.

Horizon Blue Cross Blue Shield of New Jersey v. Avee Laboratories et al.

On September 4, 2013, Horizon Blue Cross Blue Shield of New Jersey (“Horizon”) filed an amended complaint in the Superior Court of New Jersey against several defendants, including Leading Edge Recovery Center, LLC, one of the Company’s subsidiaries. Leading Edge Recovery Center, LLC formerly operated a drug and alcohol treatment facility in New Jersey. Horizon alleges the defendants submitted and caused others to submit unnecessary drug tests in violation of New Jersey law and is seeking recovery for monetary and treble damages. The Company is vigorously defending these claims and believes them to be without merit. The Company cannot provide any assurance that it will prevail in this matter, nor can it reasonably estimate its potential liability if there is an adverse outcome. Further, the Company has made a demand for indemnification upon James D. Bevell for the portion of these claims relating to the period prior to the TSN Acquisition. The Company cannot provide any assurance that it will prevail in its indemnity claim with Mr. Bevell for any portion of these claims.

The Company is aware of various other legal matters arising in the ordinary course of business. To cover these types of claims, the Company maintains insurance it believes to be sufficient for its operations, although, some claims may potentially exceed the scope of coverage in effect. Plaintiffs in these matters may request punitive or other damages that may not be covered by insurance. After taking into consideration the evaluation of such matters by the Company’s legal counsel, the Company’s management believes the outcome of these matters will not have a material impact on the Company’s consolidated financial position, results of operations and cash flows.

401(k) Plan

The Company has a qualified 401(k) savings plan (the “Plan”) which provides for eligible employees (as defined) to make voluntary contributions to the Plan. The Company makes contributions to the Plan based upon the participants’ level of participation, which is fully vested at the time of contribution. For the year ended December 31, 2012 and 2013, the Company contributions under this Plan were $40,000 and $0.2 million, respectively.

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

Other

In April 2013, the Company entered into a purchase agreement to acquire a vacant facility located in Ringwood, New Jersey for a purchase price of $6.5 million with the intent to convert the existing building into a 150-bed treatment facility. The Company paid $0.3 million in earnest money that will be applied to the purchase price if the purchase is consummated. The purchase agreement provides an extended due diligence period that ends 45 days after the Company has obtained all necessary regulatory and zoning approvals to use the property as a drug and alcohol rehabilitation center. The Company is still in the process of obtaining the necessary regulatory and zoning approvals and there are no assurances that the Company will be successful in obtaining these approvals.

In October 2013, the CEO, President and CFO of the Company, who also own membership interests in BHR, personally borrowed $1.9 million from a financial institution and used the proceeds to make a $1.9 million equity contribution to BHR. The balance of this term loan was $1.8 million at December 31, 2013. In connection with the BHR Acquisition, the Company assumed this term loan, which was subsequently refinanced effective April 15, 2014 with a new term loan facility with Reliant Bank with the Company as borrower and guarantor. This term loan matures in April 2015. The Company’s amended and restated revolving line of credit requires that this term loan be repaid with proceeds in the event of an initial public offering.

In November 2013, the Company entered into purchase agreements to acquire two outpatient centers; one in Arlington, Texas and the other in Las Vegas, Nevada. The purchase price of the Arlington facility is $0.8 million. Earnest money of $0.1 million was deposited pursuant to that agreement, which will be deducted from the purchase price at closing if the purchase is consummated. On March 28, 2014, the Company completed the purchase of this property (see Note 18). A non-refundable fee of $10,000 was also paid in accordance with the Arlington facility purchase agreement. The Las Vegas facility purchase price is $2.0 million. Earnest money of $0.1 million was deposited pursuant to the Las Vegas purchase agreement, which will be deducted from the purchase price at closing if the purchase is consummated. The purchase agreement for the Arlington facility was assigned to a subsidiary of BHR in December 2013, and the purchase agreement for the Las Vegas facility was assigned to a subsidiary of BHR in January 2014.

17. Related Parties

In addition to the related party transactions discussed elsewhere in the notes to the consolidated financial statements, the consolidated financial statements include the following related party transactions. The Company has at times received advances from or made advances to current significant stockholders. These amounts have been included in the consolidated balance sheets and notated as “related party accounts” (see Notes 3, 6 and 9).

In 2012, the Company transitioned its outsourced medical billing and collection process from third-party service providers to Clinical Revenue Management Services, LLC (“CRMS”), an alternative service provider. The two owners and officers of CRMS are the spouses of the CEO and President of the Company. Pursuant to a written service agreement, CRMS is paid (i) the greater of $0.1 million per month or 5.0% of the monthly collected revenues and (ii) 7.0% of the Professional Groups collected revenues. The service agreement includes a one year term with automatic renewals unless one party terminates the agreement with 90 days’ notice. Total amounts paid to CRMS under the service agreement during the years ended December 31, 2012 and 2013 were $0.6 million and $2.8 million, respectively. The Company recognized expense of $0.6 million in 2012 and $3.4 million in 2013 associated with this service agreement. Amounts included in accounts payable at December 31, 2012 and 2013 were $0 and $0.6 million, respectively. The Company leased office space and furniture to CRMS under a month to month arrangement in 2013, and total rental income recognized in 2013 was $0.1 million. During 2012 CRMS occupied space in the Company’s building but no rents were charged by the Company. The Company classifies these sublease proceeds as an offset to rentals and leases in the consolidated statements of income.

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

The Company is a party to certain placement agreements with Vaco, LLC (“Vaco”). One of the Company’s directors, who is also a stockholder and debt holder, is an executive officer and an equity owner of Vaco. Vaco provides the Company with accounting professionals and other staff, either on a temporary or permanent basis. Vaco is typically paid 25% of each employee’s first year salary as a placement fee or paid an hourly rate for temporary professional services. Total payments and expense recognized related to this agreement in 2012 and 2013 were $0.1 million and $0.1 million, respectively.

From March 2013 through April 2013, the Company issued 906,089 shares of common stock, at a price of $8.23 per share, which the Company’s management estimated to be fair value, to certain accredited investors, for an aggregate offering price of $7.5 million. In addition, as part of this offering, an employee of the Company subscribed for 12,150 shares of common stock at $8.23 per share. As consideration for the shares, the employee issued the Company a subscription note receivable in the amount of $0.1 million. The Company is forgiving this subscription note receivable over a 12-month period.

18. Subsequent Events

The Company has evaluated subsequent events through May 2, 2014, the date the financial statements were available to be issued. In addition to the subsequent events discussed in Notes 6, 9, 11 and 16 to the consolidated financial statements, the following events have occurred subsequent to December 31, 2013.

From February through April 2014, the Company received proceeds of $6.0 million, net of $12,500 in issuance costs, from the sale of 471,843 shares of its common stock at $12.76 per share, which the Company’s management estimated to be fair value, in an exempt common stock offering. Included within the total shares sold in the Company’s 2014 private placement were 74,449 shares sold to directors of the Company, 7,837 shares sold to the Company’s General Counsel and Secretary, 3,918 shares sold to the Company’s COO and 1,959 shares sold to one of the Company’s Vice Presidents. The share price was based, in part, on a December 2013 independent valuation analysis.

In January and February of 2014, BHR sold 8.5 units of Series A Preferred Units, valued at $50,000 per unit, with proceeds to BHR of $0.4 million, net of issuance costs of $11,300. A director of the Company purchased 5 Series A Preferred Units for $0.3 million at $50,000 per unit. After the sale, 36.5 Series A Preferred Units were outstanding totaling $1.8 million. On April 15, 2014, BHR redeemed all 36.5 outstanding Series A Preferred Units for $1.8 million.

On April 15, 2014, BHR amended and restated its Limited Liability Company Agreement which among other things to change the rights and privileges of the Series A Preferred Units. On April 15, 2014, BHR received $7.7 million in net proceeds from the sale of 160 ($50,000 per unit) of its non-controlling Series A Preferred Units to BNY Alcentra Group Holdings, Inc. (“Alcentra”). Alcentra received a 1% fee at closing and is entitled to receive a 12% per annum preferred return on its initial investment, payable quarterly in arrears. In the event of a non-payment, the preferred return compounds on a quarterly basis computed on an actual/360 day basis. In the event of non-payment for three months, the preferred return increases to 15.0%, and further increases to 18.0% if not paid beginning in the fourth month, with each increase compounding on a quarterly basis computed on an actual/360 day basis. The Series A Preferred Units contain certain embedded issuer call and holder put provisions. BHR has the option to redeem a minimum of 40 Series A Preferred Units and up to 100% of the outstanding Series A Preferred Units for $50,000 per unit, plus (i) any accrued and unpaid preferred return and (ii) a call premium of (a) 3.0% through April 15, 2015, (b) 2.0% from April 16, 2015 through April 15, 2017 and (c) no premium any time after April 15, 2017. Alcentra has a put right that, if exercised, requires BHR to redeem all of the issued and outstanding Series A Preferred Units by making a payment equal to $50,000 per unit plus the accrued but unpaid preferred return. Alcentra may exercise its put right for a period of 30 days following the 36th

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

month or 48th month after the date of issuance and at any time following the 60th month after the date of issuance. In the event of a sale of a property owned by BHR, Alcentra is entitled to the repayment of its initial capital contribution plus (i) any accrued and unpaid preferred return and (ii) any applicable call premium. As long as Alcentra owns at least 60 Series A Preferred Units less any Series A Preferred Units repurchased by BHR, distributions to affiliates of BHR are limited to $3.0 million annually.

The Series A Preferred Units generally have no voting or approval rights regarding the management of BHR. However, the holders of Series A Preferred Units are entitled to vote with respect to (i) any action that would change the rights or restrictions of the Series A Preferred Units in a way that would adversely affect such holders and (ii) the creation or issuance of any other security convertible into or exercisable for any equity security of BHR having rights, preferences or privileges senior to the common units of BHR. In addition, unanimous approval of all BHR members, including the holders of Series A Preferred Units, is required to approve the sale by BHR of more than 50% of its real property, more than 50% of the voting or economic rights of any BHR subsidiary or the merger, consolidation, sale of all or substantially all of the assets of BHR or sale of a majority of the common units of BHR.

In addition, so long as Alcentra owns at least 60 Series A Preferred Units, subject to adjustment for certain BHR redemptions, the manager of BHR may not engage in certain transactions without the approval of a majority of the Series A Preferred Unit holders, including, without limitation, the following: (i) liquidate, dissolve or wind up the business of BHR; (ii) authorize the issuance of additional Series A Preferred Units or any class or series of equity securities with rights, preferences or parity with or senior to that of the Series A Preferred Units; (iii) declare or pay any cash distribution or make any other distribution not permitted under the limited liability company agreement; (iv) pay any management or similar fees; (v) pay rebates or reduce payments payable by any primary tenants or (vi) make payments to affiliates of BHR in excess of $3.0 million per year in the aggregate.

In March 2014, the Company granted 3,713 shares of fully vested common stock to each of its five non-employee directors. The Company will recognize $0.2 million of compensation expense in the first quarter of 2014 as a result of these grants. On April 11, 2014 the Company granted 49,496 shares of restricted common stock to its General Counsel and Secretary under the Incentive Plan, of which 24,748 shares vested immediately with the remaining 24,748 shares vesting on April 10, 2015. The fair value on the award date was $12.76 per share, as estimated by the Company’s management. As a result of the award, the Company will record $0.3 million of compensation expense, $0.2 million of additional compensation expense to satisfy the employee’s personal tax obligation related to the vesting of the grant during the second quarter of 2014, and $0.3 million ratably over the one-year vesting period. Additionally, on April 11, 2014, the Company granted 3,019 shares of its common stock to a non-executive employee. The Company will record $39,000 of compensation expense and $30,000 of additional compensation expense to satisfy the employee’s personal tax obligation related to the stock grant during the second quarter of 2014. On April 17, 2014, the Company redeemed a total of 9,113 shares of its common stock at $12.76 per share, which the Company’s management estimates to be fair value, for an aggregate redemption price of $0.1 million.

On March 28, 2014, the Company completed the purchase of a property in Arlington, Texas for $0.7 million.

On April 15, 2014, the Company entered into a Second Amended and Restated Credit Facility (the “Credit Facility”) with Wells Fargo Bank, National Association (the “Agent”). The Credit Facility makes available to the Company a $15.0 million revolving line of credit (the “Amended Revolving Line”) and two term loans in the outstanding principal amounts of $0.6 million (“Term Loan A”) and $1.5 million (“Term Loan B”).

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

The Amended Revolving Line bears interest at one-month LIBOR, plus an applicable margin that is determined by the Company’s leverage ratio, as defined by the agreement, at the end of each quarter. A quarter-end leverage ratio of 4.75 to 1.00 or above results in an applicable margin of 3.00%, a ratio below 4.75 to 1.00 and equal to or above 4.00 to 1.00 results in an applicable margin of 2.75%, and a ratio below 4.00 to 1.00 results in an applicable margin of 2.50%. Term Loan A bears interest at LIBOR plus 3.15%, and Term Loan B bears interest at LIBOR plus 5.00%. The borrowing base for the Amended Revolving Line is 70% of the Company’s eligible accounts receivable and was established with the understanding that, among other things, the aggregate of all returns, rebates, discounts, credits and allowances, exclusive of the initial adjustment to record net revenues at the time of billing, for the immediately preceding three months will be less than 20% of gross revenues for such period (up from the previous restriction of 8%). If the aggregate of all returns, rebates, discounts, credits and allowances, exclusive of the initial adjustment to record net revenues at the time of billing, for the immediately preceding three months is greater than 20% of gross revenues for such period, or if there exists any other matters, events, conditions or contingencies that the Agent reasonably believes may affect payment of any portion of the Company’s accounts, the Agent may reduce the borrowing base from 70% of the Company’s eligible accounts receivable to a lower percentage.

The amendment and restatement removed the previous covenants that required the Company to maintain a minimum tangible net worth ratio and minimum net income. The Credit Facility requires the Company to achieve minimum net revenues and adjusted EBITDA for each quarter, determined on a rolling four quarters basis, of no less than 85% of net revenues and adjusted EBITDA for the immediately preceding four quarters. The Credit Facility generally defines adjusted EBITDA as consolidated net income plus (i) interest expense, (ii) depreciation and amortization expense, (iii) tax expense, (iv) non-cash stock compensation, (v) one-time legal and restructuring costs incurred in 2014 in connection with the AAC private placement, the Reorganization Transactions, the BHR preferred equity transactions, and this offering in an amount not to exceed $2.5 million, (vi) one-time legal, accounting and other transaction costs incurred in connection with a permitted acquisition in 2014 or in any subsequent fiscal year in an aggregate amount not to exceed $0.2 million in any fiscal year, (vii) one-time settlement costs paid on or about April 9, 2014, in connection with certain wage and settlement charges in California in an amount not to exceed $2.5 million, (viii) one-time restructuring costs incurred in 2013 in connection with the closing of the Leading Edge operations and the consolidation of call centers in an amount not to exceed $0.8 million, and (ix) to the extent approved by Wells Fargo Bank in writing, other one-time and non-recurring charges.

The Credit Facility also requires the Company to achieve a fixed charge coverage ratio of not less than 1.25 to 1.00 for each quarter, determined on a rolling four quarter basis, and achieve a liquidity covenant (as described in the agreement) of no less than $9.0 million on and as of July 14, 2014. Finally, the Credit Facility includes a maximum leverage ratio covenant, whereby the ratio of funded debt to EBITDA must not be greater than the ratios set forth below on a rolling four quarter basis:

 

Fiscal Quarter End

   Maximum Leverage Ratio  

June 30, 2014

     5.00:1.00   

September 30, 2014

     4.75:1.00   

December 31, 2014 and thereafter

     3.75:1.00   

The Credit Facility limits aggregate capital expenditures (as defined by the agreement and which exclude, among other items, capital expenditures made by BHR and its subsidiaries that are funded with debt permitted under the agreement or proceeds from this offering and permitted acquisitions under the agreement) to $3.0 million in each fiscal year and limits capital lease debt and other purchase money debt to $2.3 million.

 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

The Credit Facility also contains customary events of default including, but not limited to, failure to make payments under the Credit Facility, materially incorrect representations, breaches of covenants (subject to a 20 day cure period in the case of certain covenants), cross-default to any other material indebtedness, bankruptcy and insolvency events, change of control, and the failure of guarantees or security to remain in full force and effect.

As of April 15, 2014, the Amended Revolving Line had an outstanding balance of $13.1 million, the interest rate was 3.15%, and the maximum unused available credit was $0.9 million based upon the borrowing base restrictions.

As discussed in Note 11, certain common shares issued in 2008 under the previous Board of Directors exceeded the number of shares duly authorized by the Company’s Articles of Incorporation. These common shares are classified as mezzanine equity in the consolidated balance sheets because they do not meet the definition of permanent equity as a result of these legal imperfections. To cure these legal imperfections and in preparation for an initial public offering, in the first quarter of 2014, Holdings initiated a voluntary private share exchange with certain of the Company’s stockholders whereby Holdings offered to certain of the Company’s stockholders the opportunity to receive one share of Holdings common stock for (i) each share of the Company’s common stock held by such stockholders and (ii) a release from claims arising from or related to the share imperfections described in Note 11 (collectively, the “Private Share Exchange”). The Private Share Exchange was conditioned upon, among other things, holders of the Company’s common stock who participated in the Share Exchange validly assigning and transferring to Holdings at least 90% of the outstanding shares of the Company prior to the expiration of the Private Share Exchange. The Private Share Exchange expired in April 2014, and at the expiration of the Private Share Exchange 93.6% of the holders of the Company’s common stock had exchanged their shares for shares of common stock of Holdings, and the Company became a majority-owned subsidiary of Holdings. The transaction between the Company and Holdings was accounted for similar to a common control transaction resulting in the assets, liabilities and equity of the Company being carried over at their historical basis.

Substantially concurrent with the Private Share Exchange, Holdings acquired all of the outstanding common membership interests of BHR by issuing 521,999 shares of Holdings common stock and $3.0 million in cash and the assumption of a $1.8 million term loan from a financial institution to our CEO, President and CFO (collectively, the “BHR Acquisition”). The original proceeds from this loan were used to repay a loan related to Greenhouse Real Estate, LLC and was accounted for as an additional capital contribution in BHR. Holdings refinanced the assumed loan and is required to make monthly principal payments of $35,855 to a financial institution, plus 5.0% interest and a balloon payment of $1.4 million in April 2015. In the event of an initial public offering (“IPO”), prior to April 2015 the Credit Facility requires that the Company immediately repay the $1.8 million assumed and refinanced term loan with proceeds from the IPO. Prior to the BHR Acquisition, BHR was controlled by the CEO, President and CFO of the Company. BHR owns the real property associated with treatment facilities, which are leased to the Company, as well as other properties that are currently in development or are being held for future development. The acquisition of BHR was accounted for as an acquisition of additional ownership interests in a variable interest entity that does not result in a change of control of that subsidiary, as BHR was already being consolidated as a VIE in accordance with ASC 810 (Consolidation) and, accordingly, we recognized $4.7 million of the $11.8 million in fair value of consideration transferred (consisting of $3.0 million cash consideration, the $1.8 million term loan assumed and the net deferred tax assets of $0.1 million). The Company eliminated the noncontrolling interest attributable to BHR of $3.7 million with the excess of fair value over the carrying value of noncontrolling interest recorded as a reduction to additional paid-in capital of $1.0 million.

Additionally, substantially concurrent with the Private Share Exchange and the BHR Acquisition, Holdings acquired all of the outstanding membership interests of CRMS in exchange for $0.5 million in cash and

 

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AMERICAN ADDICTION CENTERS, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

149,144 shares of Holdings common stock (collectively, the “CRMS Acquisition”, and collectively with the Private Share Exchange and BHR Acquisition, the “Reorganization Transactions”). Holdings accounted for the CRMS Acquisition as a business combination based on the fair value of the consideration transferred. While the purchase price allocation is preliminary, Holdings expects to recognize approximately $2.4 million of goodwill in connection with the CRMS Acquisition.

The Company’s management estimated the fair value of shares of restricted common stock of Holdings issued in connection with the BHR Acquisition and the CRMS Acquisition to be $13.41 per share as of April 11, 2014. In addition to factoring in the prior valuation analyses described above, the Company also analyzed a new valuation report prepared by an independent third party with respect to the valuation of Holdings taking into account the Private Share Exchange, CRMS Acquisition and BHR Acquisition. In particular, the valuation report analyzed the potential impact of the then-proposed Reorganization Transactions on the valuation of Holdings, such as the increase in 2013 pro forma net income as a result of BHR results of operations being included for all of 2013. The valuation report also noted that the impact of the BHR Acquisition on the enterprise value would be mixed, as the additional EBITDA generated at the Holdings level due to recapture rents and cash and non-cash expenses was not sufficient to overcome the negative impact on enterprise value of BHR’s debt outstanding for the entire year. With respect to CRMS, the analysis determined that it would allow the recapture of additional EBITDA (on a pro forma basis for 2013) due to a combination of recapture revenues (commissions no longer paid) and the expected cost savings. In determining the fair value of our common stock, the Company also considered the strong investor demand in the recent private placement of AAC common stock from February 2014 through April 2014 at $12.76 per share, the improved projected results of operations for the remainder of 2014, positive revenue trends and the higher probability of an initial public offering in 2014. Based on the foregoing analysis, the Company determined the fair value of Holdings common stock as of April 11, 2014 to be $13.41 per share.

As a result of the Reorganization Transactions, Holdings now owns (i) 93.6% of the outstanding common stock of the Company, (ii) 100% of the outstanding common membership interests in BHR and (iii) 100% of the outstanding membership interests in CRMS.

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

 

     December 31,
2013
     June 30,
2014
(Unaudited)
 
     (in thousands except share amounts)  

Assets

     

Current assets

     

Cash and cash equivalents (variable interest entity—2013: $441; 2014: $52)

   $ 2,012       $ 2,382   

Accounts receivable, net of allowances—(variable interest entity—2013: $169; 2014: $479)

     24,567         26,635   

Notes and other receivables—related party

             488   

Deferred tax assets

     676           

Prepaid expenses and other current assets (variable interest entity—2013: $173; 2014: $6)

     2,274         3,375   
  

 

 

    

 

 

 

Total current assets

     29,529         32,880   
  

 

 

    

 

 

 

Property and equipment, net (variable interest entity—2013: $29,257; 2014: $0)

     37,008         44,311   

Goodwill

     10,863         12,702   

Intangible assets, net

     3,496         3,209   

Note receivable—related party

     250           

Other assets (variable interest entity—2013: $142; 2014: $0)

     492         650   
  

 

 

    

 

 

 

Total assets

   $ 81,638       $ 93,752   
  

 

 

    

 

 

 

— The assets denoted as assets of the consolidated variable interest entity (VIE) can only be used to settle obligations of the consolidated VIE.

See accompanying notes to condensed consolidated financial statements.

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

 

     December 31,
2013
    June 30,
2014
(Unaudited)
 
     (in thousands except share amounts)  

Liabilities, Mezzanine Equity and Stockholders’ Equity

    

Current liabilities

    

Accounts payable

   $ 1,895      $ 2,853   

Accrued liabilities (variable interest entity—2013: $172; 2014: $149)

     10,455        8,086   

Current portion of deferred tax liabilities

            15   

Current portion of long-term debt (variable interest entity—2013: $12,932; 2014: $0)

     15,164        17,406   

Current portion of long-term debt—related party

     795        791   
  

 

 

   

 

 

 

Total current liabilities

     28,309        29,151   

Deferred tax liabilities (variable interest entity—2013: $23; 2014: $0)

     2,329        1,585   

Long-term debt, net of current portion (variable interest entity—2013: $8,616; 2014: $0)

     23,341        25,221   

Long-term debt—related party, net of current portion

     3,775        3,376   

Other long-term liabilities

     159        87   
  

 

 

   

 

 

 

Total liabilities

     57,913        59,420   
  

 

 

   

 

 

 

Commitments and contingencies (Note 15)

    

Mezzanine equity including noncontrolling interest (see Note 11)

    

Noncontrolling interest—American Addiction Centers, Inc. Common stock

     10,442        53   

Noncontrolling interest—Series A Preferred Units (variable interest entity in 2013)

     1,400          

Noncontrolling interest—Series A Preferred Units

            7,782   
  

 

 

   

 

 

 

Total mezzanine equity including noncontrolling interest

     11,842        7,835   
  

 

 

   

 

 

 

Stockholders’ equity

    

AAC Holdings, Inc. preferred stock, $0.001 par value: 5,000,000 shares authorized; none issued and outstanding

              

AAC Holdings, Inc. common stock, $0.001 par value: 70,000,000 shares authorized, 9,975,885 shares issued and outstanding at June 30, 2014

            10   

AAC Holdings, Inc. common stock subscribed, net of subscription receivable of $8 at June 30, 2014

            92   

American Addiction Centers, Inc. common stock, $0.001 par value: 15,000,000 shares authorized; 2,481,114 shares issued and 2,036,680 outstanding at December 31, 2013

     2          

American Addiction Centers, Inc. common stock subscribed, net of subscription receivable of $58 at December 31, 2013

     42          

Additional paid-in capital

     9,450        22,413   

Treasury stock, at cost

     (3,671       

Retained earnings

     2,360        3,893   
  

 

 

   

 

 

 

Total stockholders’ equity of AAC Holdings, Inc .

     8,183        26,408   

Noncontrolling interest

     3,700        89   
  

 

 

   

 

 

 

Total stockholders’ equity including noncontrolling interest

     11,883        26,497   
  

 

 

   

 

 

 

Total liabilities, mezzanine equity and stockholders’ equity

   $ 81,638      $ 93,752   
  

 

 

   

 

 

 

— The denoted VIE liabilities are only claims against the general credit of the Company to the extent that the Company is liable under its guarantee of the VIE note payable to a financial institution of $21,548 and $0 at December 31, 2013 and June 30, 2014, respectively.

See accompanying notes to condensed consolidated financial statements.

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF INCOME

 

     Six Months Ended June 30,  
             2013                     2014          
     (in thousands, except share and per share
amounts)
 

Revenues

   $ 59,331      $ 59,203   
  

 

 

   

 

 

 

Operating expenses

    

Salaries, wages and benefits

     21,732        24,124   

Advertising and marketing

     6,588        7,079   

Professional fees

     4,706        4,895   

Client related services

     3,567        5,211   

Other operating expenses

     6,213        5,551   

Rentals and leases

     2,772        940   

Provision for doubtful accounts

     4,820        6,288   

Litigation settlement

     2,500        240   

Restructuring

     551          

Depreciation and amortization

     1,399        2,228   
  

 

 

   

 

 

 

Total operating expenses

     54,848        56,556   
  

 

 

   

 

 

 

Income from operations

     4,483        2,647   

Interest expense

     784        705   

Other (income) expense, net

     (27     15   
  

 

 

   

 

 

 

Income before income tax expense

     3,726        1,927   

Income tax expense

     1,745        859   
  

 

 

   

 

 

 

Net income

     1,981        1,068   

Less: net loss (income) attributable to noncontrolling interest

     (343     668   
  

 

 

   

 

 

 

Net income attributable to AAC Holdings, Inc. stockholders

     1,638        1,736   

Deemed contribution-redemption of Series B Preferred Stock

     1,000          

BHR Series A Preferred Unit dividend

            (203
  

 

 

   

 

 

 

Net income available to AAC Holdings, Inc. common stockholders

   $ 2,638      $ 1,533   
  

 

 

   

 

 

 

Basic earnings per common share

   $ 0.30      $ 0.16   

Diluted earnings per common share

   $ 0.30      $ 0.16   

Weighted-average shares outstanding:

    

Basic

     8,671,942        9,510,427   

Diluted

     8,734,934        9,544,420   

See accompanying notes to condensed consolidated financial statements.

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

 

     Six Months Ended June 30,  
             2013                     2014          
     (in thousands)  

Cash flows from operating activities:

    

Net income

   $ 1,981      $ 1,068   

Adjustments to reconcile net income to net cash provided by operating activities:

    

Provision for doubtful accounts

     4,820        6,288   

Depreciation and amortization

     1,399        2,228   

Equity compensation

     350        1,112   

Amortization of discount on notes payable

     84        17   

Deferred income taxes

     (561     (39

Changes in operating assets and liabilities (excluding acquisitions):

    

Accounts receivable

     (7,958     (7,904

Prepaid expenses and other assets

     (188     (1,101

Accounts payable

     411        958   

Accrued liabilities

     (415     (2,585

Other long term liabilities

            (72
  

 

 

   

 

 

 

Net cash provided by (used in) operating activities

     (77     (30
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Purchase of property and equipment

     (8,675     (8,868

Purchase of intangible assets

     (220       

Issuance of notes and other receivables—related parties

            (488

Collection of notes and other receivables—related parties

            250   

Acquisition of subsidiaries, net of cash acquired of $149

            (3,351

(Purchase) reimbursement of other assets

            (158
  

 

 

   

 

 

 

Net cash used in investing activities

     (8,895     (12,615
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Proceeds from revolving line of credit, net

     3,801        500   

Proceeds from long-term debt

     6,587        3,850   

Proceeds from long-term debt—related party

     50          

Payments on long-term debt and capital leases

     (151     (2,288

Repayment of long-term debt—related party

     (1,110     (404

Repurchase of common stock

     (5,067     (116

Proceeds from sale of common stock

     7,462        6,089   

Proceeds from sale of BHR Series A Preferred Units

            8,203   

Redemption of BHR Series A Preferred Units

            (1,825

Dividends paid

            (79

Distributions to noncontrolling interest

     (3,269     (915
  

 

 

   

 

 

 

Net cash provided by financing activities

     8,303        13,015   
  

 

 

   

 

 

 

Net increase (decrease) in cash and cash equivalents

     (669     370   

Cash and cash equivalents, beginning of period

     740        2,012   
  

 

 

   

 

 

 

Cash and cash equivalents, end of period

   $ 71      $ 2,382   
  

 

 

   

 

 

 

(continued on next page)

 

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Table of Contents

AAC HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

 

     Six months ended June 30,  
             2013                      2014          
     (in thousands)  

Supplemental disclosures of cash flow information:

     

Cash and cash equivalents paid for:

     

Interest

   $ 475       $ 67   

Income taxes

   $ 3,079       $ 161   

Supplemental information on non-cash investing and financing transactions:

     

BHR Acquisition:

     

Purchase Price

   $       $ 11,759   

Assumption of debt

             (1,759

Buyer common stock issued

             (7,000
  

 

 

    

 

 

 

Cash paid for acquisition

             3,000   
  

 

 

    

 

 

 

CRMS Acquisition:

     

Purchase Price

   $       $ 2,500   

Buyer common stock issued

             (2,000
  

 

 

    

 

 

 

Cash paid for acquisition

             500   
  

 

 

    

 

 

 

Conversion of long-term debt—related party into common stock

     2,000           

Acquisition of equipment through capital lease

             285   

Accrued dividends BHR Series A Preferred units

             203   

Accrued dividends of a variable interest entity

   $       $ 61   

See accompanying notes to condensed consolidated financial statements.

 

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Table of Contents

AAC HOLDINGS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY

 

(in thousands except per
share amounts)

  Common Stock –
American Addiction
Centers, Inc.
    Common Stock –
AAC Holdings, Inc.
    Subscribed     Subscriptions
Receivable
    Additional
Paid-in

Capital/
(Distributions
in Excess of
Paid-in

Capital)
    Treasury
Stock
    Retained
Earnings
    Total
Stockholders’
Equity
(Deficit)

of American
AAC
Holdings,

Inc.
    Non-
Controlling
Interests
    Total
Stockholders’
Equity
(Deficit)
 
  Shares
Outstanding
    Amount     Shares
Outstanding
    Amount                  

Balance at December 31, 2013

    2,036,680      $ 2             $      $ 100      $ (58   $ 9,450      $ (3,671   $ 2,360      $ 8,183      $ 3,700      $ 11,883   

Common stock issued

    471,843        1                             50        6,017                      6,068               6,068   

Exercise of common stock warrants

    71,705                                           72                      72               72   

Common stock granted and issued under stock incentive plan

    71,080                                           1,062                      1,062               1,062   

Accrued dividends to mezzanine noncontrolling interests

                                                                          (61     (61

Distribution to noncontrolling interest holders, net

                                                                          (915     (915

Redemption of common stock

    (9,113                                               (116            (116            (116

Private share exchange, see Note 3

    (2,642,195     (3     9,304,742        9                      4,897        3,787               8,690        1,694        10,384   

BHR acquisition

                  521,999        1                      (1,085                   (1,084     (3,661     (4,745

CRMS acquisition

                  149,144                             2,000                      2,000               2,000   

Accrued dividends BHR Series A Preferred Units

                                                            (203     (203            (203

Net income (loss)

                                                            1,736        1,736        (668     1,068   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Balance at June 30, 2014

         $        9,975,885      $ 10      $ 100      $ (8   $ 22,413      $      $ 3,893      $ 26,408      $ 89      $ 26,497   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

See accompanying notes to condensed consolidated financial statements.

 

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Table of Contents

AAC HOLDINGS, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

1. Description of Business

AAC Holdings, Inc., a Nevada corporation (collectively with its subsidiaries, the “Company” or “Holdings”), was incorporated on February 12, 2014 for the purpose of acquiring all the common stock of American Addiction Centers, Inc. (“AAC”) and to engage in certain reorganization transactions as more fully described in Note 3. The Company is headquartered in Brentwood, Tennessee and provides substance abuse treatment services for individuals with drug and alcohol addiction. The Company also provides treatment services for clients struggling with behavioral health disorders, including disorders associated with obesity. Currently, the Company, through its subsidiaries, operates six substance abuse treatment facilities located in Texas, California, Florida and Nevada and a facility in Tennessee that provides treatment services for men and women who struggle with obesity-related behavioral disorders. A subsidiary of the Company had an arrangement with a treatment facility in California to provide addiction and chemical dependency services to clients sourced by the subsidiary. The subsidiary discontinued using this treatment facility in April 2013. On January 1, 2013, the Desert Hope treatment facility in Las Vegas, Nevada obtained its license for 148 residential beds and began accepting clients.

2. Basis of Presentation

Principles of Consolidation

The Company conducts its business through limited liability companies and C-corporations, each of which is a majority owned subsidiary of the Company. The accompanying consolidated financial statements include the accounts of the Company, its wholly or majority owned subsidiaries, the accounts of variable interest entities (“VIEs”) in which the Company is the primary beneficiary, and certain professional groups through rights granted to the Company by contract to manage and control an entity’s business. All intercompany transactions and balances have been eliminated in consolidation.

The Private Share Exchange transaction between the Company and AAC’s stockholders (as discussed in Note 3) was accounted for similar to a common control transaction resulting in the assets, liabilities, and equity of AAC being carried over at historical basis. At the time of the Private Share Exchange, Holdings was a shell company that had not conducted any business and had no material assets or liabilities. As such, the historical financial statements presented for periods prior to the Private Share Exchange represent the historical results of operations of AAC.

During the six months ended June 30, 2013, the Company consolidated one real estate VIE. During the six months ended June 30, 2014, the Company consolidated one real estate VIE, Behavioral Healthcare Realty, LLC (“BHR”), through April 15, 2014 when BHR was acquired by the Company. The Company also consolidated five professional groups (“Professional Groups”) that constitute VIEs as of June 30, 2014 and none as of June 30, 2013. BHR leased two treatment facilities to the Company under long-term triple net leases and was renovating and constructing additional treatment facilities that it planned to lease to the Company. The Company was the primary beneficiary as a result of its guarantee of BHR’s debt prior to the BHR Acquisition. The Company has management services arrangements with five Professional Groups that provide medical services to the Company’s treatment facilities. The Professional Groups are responsible for the supervision and delivery of medical services to the Company’s clients. Based on the Company’s ability to direct the activities that most significantly impact the economic performance of the Professional Groups, provide necessary funding and the obligation and likelihood of absorbing all expected gains and losses, the Company has determined that it is the primary beneficiary. The accompanying consolidated balance sheets as of December 31, 2013 and June 30, 2014 include assets of $30.2 million and $0.5 million, respectively, and liabilities of $21.7 million and $0.2 million, respectively, related to the VIEs. The accompanying consolidated statements of income for the six months ended June 30, 2013 and 2014 include net income (loss) attributable to noncontrolling interest of $0.3 million and ($0.7) million, respectively, related to the VIEs.

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

 

The accompanying condensed consolidated financial statements are unaudited, with the exception of the December 31, 2013 balance sheet which was derived from audited financial statements. These consolidated condensed financial statements have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim reporting. Certain disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“US GAAP”) have been condensed or omitted pursuant to such rules and regulations.

In presenting the consolidated condensed financial statements in accordance with US GAAP, management makes estimates and assumptions that affect the amounts reported and related disclosures. Estimates, by their nature, are based on judgments and available information. Accordingly, actual results could differ from those estimates. In management’s opinion, the consolidated condensed financial statements contain all normal recurring adjustments necessary for a fair presentation of interim results reported. The results of operations reported for interim periods are not necessarily indicative of the results of operations for the entire year or any subsequent interim period. These financial statements should be read in conjunction with the audited financial statements of the Company included elsewhere in this prospectus.

Certain reclassifications have been made to prior periods to conform to the current period presentation.

3. Reorganization Transactions

On April 15, 2014, the Company completed the following transactions which were all completed substantially concurrently (collectively, the “Reorganization Transactions”):

 

    A voluntary private share exchange with certain stockholders of AAC, whereby holders representing 93.6% of the outstanding shares of common stock of AAC exchanged their shares on a one-for-one basis for shares of Holdings common stock;

 

    The acquisition of all of the outstanding common membership interests of Behavioral Healthcare Realty, LLC (“BHR”), an entity controlled by related parties, which through its subsidiaries owns properties located in Florida, Nevada and Texas, in exchange for $3.0 million in cash, the assumption of a $1.8 million term loan and 521,999 shares of the Company’s common stock; and

 

    The acquisition of all of the outstanding membership interests of Clinical Revenue Management Services, LLC (“CRMS”), an entity controlled by related parties, which provides client billing and collection services for the Company, in exchange for $0.5 million in cash and 149,144 shares of the Company’s common stock.

As a result of the foregoing transactions, the Company now owns (i) 93.6% of the outstanding common stock of AAC, (ii) 100% of the outstanding common membership interests in BHR, and (iii) 100% of the outstanding membership interests in CRMS. To help fund or facilitate these transactions, the following additional financing transactions were undertaken in 2014 prior to or in connection with the aforementioned transactions: (i) AAC sold 471,843 shares of its common stock in a private placement to certain accredited investors from February 2014 through April 2014, with net proceeds of $6.0 million, (ii) BHR sold 8.5 Series A Preferred Units in a private placement to certain accredited investors in January and February 2014 with net proceeds of $0.4 million (See Note 11), (iii) BHR redeemed all of the outstanding 36.5 Series A Preferred Units from certain accredited investors in April 2014 (See Note 11) and (iv) BHR sold 160 new Series A Preferred Units in a private placement to an accredited investor in April 2014 with net proceeds of $7.8 million (See Note 11).

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

 

Private Share Exchange

Certain common shares issued in 2008 under the previous Board of Directors exceeded the number of shares duly authorized by AAC’s Articles of Incorporation. These common shares were previously classified as mezzanine equity in the consolidated balance sheets because they did not meet the definition of permanent equity as a result of these legal imperfections. To cure these legal imperfections and in preparation for an initial public offering, in the first quarter of 2014, the Company initiated a voluntary private share exchange with certain of AAC’s stockholders whereby the Company offered to certain of AAC’s stockholders the opportunity to receive one share of the Company’s common stock for (i) each share of AAC’s common stock held by such stockholders and (ii) a release from claims arising from or related to the share imperfections (collectively, the “Private Share Exchange”). The Private Share Exchange was conditioned upon, among other things, holders of AAC’s common stock who participated in the Private Share Exchange validly assigning and transferring to the Company at least 90% of the outstanding shares of AAC prior to the expiration of the Private Share Exchange. The Private Share Exchange expired in April 2014, and at the expiration of the Private Share Exchange holders representing 93.6% of AAC’s common stock had exchanged their shares for shares of common stock of the Company, and AAC became a majority-owned subsidiary of the Company. The Private Share Exchange was accounted for similar to a common control transaction resulting in the assets, liabilities and equity of AAC being carried over at their historical basis. Shares of AAC common stock that were not exchanged remained in mezzanine equity or stockholders’ equity based on the pre-exchange classification at carrying value.

Behavioral Healthcare Realty, LLC Acquisition

On April 15, 2014, BHR redeemed all 36.5 outstanding Series A Preferred Units for $1.8 million. These former holders of Series A Preferred Units used the proceeds from the redemption to purchase 143,017 shares of AAC’s common stock at $12.76 per share as part of an exempt common stock offering. Included in the aforementioned transaction, nine of the Series A Preferred Units were redeemed from a director and a relative of a director who purchased 35,285 shares of AAC’s common stock valued at approximately $450,000.

Simultaneously, BHR amended and restated its Limited Liability Company Agreement which among other things changed the rights and privileges of the Series A Preferred Units. On April 15, 2014, BHR received $7.8 million in net proceeds from the sale of 160 ($50,000 per unit) of its non-controlling Series A Preferred Units to BNY Alcentra Group Holdings, Inc. (“Alcentra”). Alcentra received a 1% fee at closing and is entitled to receive a 12% per annum preferred return on its initial investment, payable quarterly in arrears. In the event of a non-payment, the preferred return compounds on a quarterly basis computed on an actual/360 day basis. In the event of non-payment for three months, the preferred return increases to 15.0%, and further increases to 18.0% if not paid beginning in the fourth month, with each increase compounding on a quarterly basis computed on an actual/360 day basis. The Series A Preferred Units contain certain embedded issuer call and holder put provisions. BHR has the option to redeem a minimum of 40 Series A Preferred Units and up to 100% of the outstanding Series A Preferred Units for $50,000 per unit, plus (i) any accrued and unpaid preferred return and (ii) a call premium of (a) 3.0% through April 15, 2015, (b) 2.0% from April 16, 2015 through April 15, 2017 and (c) no premium any time after April 15, 2017. Alcentra has a put right that, if exercised, requires BHR to redeem all of the issued and outstanding Series A Preferred Units by making a payment equal to $50,000 per unit plus the accrued but unpaid preferred return. Alcentra may exercise its put right for a period of 30 days following the 36th month or 48th month after the date of issuance and at any time following the 60th month after the date of issuance. In the event of a sale of a property owned by BHR, Alcentra is entitled to the repayment of its initial capital contribution plus (i) any accrued and unpaid preferred return and (ii) any applicable call premium. As long as Alcentra owns at least 60 of the Series A Preferred Units less any Series A Preferred Units repurchased by BHR, distributions to affiliates of BHR are limited to $3.0 million annually.

 

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Table of Contents

AAC HOLDINGS, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

 

The Series A Preferred Units generally have no voting or approval rights regarding the management of BHR. However, the holders of Series A Preferred Units are entitled to vote with respect to (i) any action that would change the rights or restrictions of the Series A Preferred Units in a way that would adversely affect such holders and (ii) the creation or issuance of any other security convertible into or exercisable for any equity security of BHR having rights, preferences or privileges senior to the common units of BHR. In addition, unanimous approval of all BHR members, including the holders of Series A Preferred Units, is required to approve the sale by BHR of more than 50% of its real property, more than 50% of the voting or economic rights of any BHR subsidiary or the merger, consolidation, sale of all or substantially all of the assets of BHR or sale of a majority of the common units of BHR.

In addition, so long as Alcentra owns at least 60 Series A Preferred Units, subject to adjustment for certain BHR redemptions, the manager of BHR may not engage in certain transactions without the approval of a majority of the Series A Preferred Unit holders, including, without limitation, the following: (i) liquidate, dissolve or wind up the business of BHR; (ii) authorize the issuance of additional Series A Preferred Units or any class or series of equity securities with rights, preferences or parity with or senior to that of the Series A Preferred Units; (iii) declare or pay any cash distribution or make any other distribution not permitted under the limited liability company agreement; (iv) pay any management or similar fees; (v) pay rebates or reduce payments payable by any primary tenants or (vi) make payments to affiliates of BHR in excess of $3.0 million per year in the aggregate.

Substantially concurrent with the Private Share Exchange, the Company acquired all of the outstanding common membership interests of BHR by issuing 521,999 shares of Company common stock (at a fair value of $13.41 per share as determined by the Company), paying $3.0 million in cash and assuming a $1.8 million term loan from a financial institution to our CEO, President and CFO (collectively, the “BHR Acquisition”). The original proceeds from this loan were used to repay a loan related to Greenhouse Real Estate, LLC and was accounted for as an additional capital contribution in BHR. The Company refinanced the assumed term loan and is required to make monthly principal payments of $35,855 to a financial institution, plus 5.0% interest and a balloon payment of $1.4 million in April 2015. In the event of an initial public offering (“IPO”) prior to April 2015, the Credit Facility requires that the Company immediately repay the $1.8 million assumed and refinanced term loan with proceeds from the IPO. Prior to the BHR Acquisition, BHR was controlled by the CEO, President and CFO of the Company. BHR owns the real property associated with treatment facilities, which are leased to the Company, as well as other properties that are currently in development or are being held for future development. The BHR Acquisition was accounted for as a common control transaction as BHR was already being consolidated as a VIE in accordance with ASC 810 and, accordingly, the Company recognized $4.7 million of the $11.8 million in fair value of consideration transferred (consisting of $3.0 million cash consideration, the $1.7 million loan assumed and the net deferred tax assets of $0.1 million). The Company eliminated the noncontrolling interest attributable to BHR of $3.7 million with the excess of fair value over the carrying value of noncontrolling interest recorded as a reduction to additional paid-in capital of $1.0 million.

Clinical Revenue Management Services, LLC Acquisition

On April 15, 2014, the Company acquired all the outstanding membership interests of CRMS in exchange for $0.5 million in cash and 149,144 common shares of the Company’s common stock (at a fair value of $13.41 per common share as determined by the Company) for total consideration paid of $2.5 million (collectively, the “CRMS Acquisition”). The purchase price was based upon a third party valuation report of CRMS obtained by the Company. CRMS provides billing and collections services to the Company and has no customers other than the Company. After this acquisition, all billing and collection services for the Company are performed by a wholly owned subsidiary. Prior to its acquisition by the Company, CRMS was owned by the

 

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spouses of the Company’s CEO and President. The purchase price resulted in a premium to the fair value of the net assets acquired and, correspondingly, the recognition of goodwill. The amount recorded for goodwill is consistent with the Company’s intentions for the acquisition.

The acquisition was accounted for as a business combination. The Company recorded the transaction based upon the fair value of the consideration paid. This consideration was allocated to the assets acquired and liabilities assumed at the acquisition date based on their fair values as follows (in thousands):

 

Cash

   $ 149   

Accounts receivable

     452   

Property and equipment

     91   

Goodwill

     1,810   
  

 

 

 

Total assets acquired

     2,502   
  

 

 

 

Accrued liabilities

     2   
  

 

 

 

Total liabilities assumed

     2   
  

 

 

 

Net assets acquired

   $ 2,500   
  

 

 

 

The goodwill recognized is deductible for income tax purposes. Acquisition related costs total $0.1 million and were expensed in other operating expenses in the condensed consolidated statement of income for the six month period ended June 30, 2014.

The results of operations for CRMS from the acquisition date of April 15, 2014 are included in the condensed consolidated statement of income for the six month period ended June 30, 2014. The following presents the unaudited pro forma revenues and income before income taxes of the combined entity had the CRMS Acquisition occurred on the first day of the period presented (in thousands):

 

    Revenues     Income before
income taxes
 

Combined pro forma from January 1, 2013 – June 30, 2013

  $ 59,331      $ 4,249   

Combined pro forma from January 1, 2014 – June 30, 2014

  $ 59,203      $ 1,811   

Fair Value of Shares Issued

The Company determined the fair value of shares of restricted common stock of the Company issued in connection with the BHR Acquisition and the CRMS Acquisition to be $13.41 per share. Management analyzed a valuation report prepared by an independent third party with respect to the valuation of the Company taking into account the Private Share Exchange, the BHR Acquisition and the CRMS Acquisition. In particular, the valuation report analyzed the potential impact of the then-proposed Reorganization Transactions on the valuation of the Company, such as the increase in 2013 pro forma net income as a result of BHR results of operations being included for all of 2013. The valuation report also noted that the impact of the BHR Acquisition on the enterprise value would be mixed, as the additional EBITDA generated at the Company level due to recapture rents and cash and non-cash expenses was not sufficient to overcome the negative impact on enterprise value of BHR’s debt outstanding for the entire year. With respect to CRMS, the analysis determined that it would allow the recapture of additional EBITDA (on a pro forma basis for 2013) due to a combination of recapture revenues (commissions no longer paid) and the expected cost savings. In determining the fair value of the Company’s common stock, management also considered investor demand in the recent private placement of AAC common stock from February 2014 through April 2014 at $12.76 per share, the improved projected results of operations of the

 

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remainder of 2014 and the higher probability of an initial public offering in 2014. Based on the foregoing analysis, the Company determined the fair value of the Company’s common stock as of April 11, 2014 to be $13.41 per share.

4. General and Administrative Costs

The majority of the Company’s expenses are “cost of revenue” items. Costs that could be classified as general and administrative expenses include the Company’s corporate overhead costs, which were $14.7 million and $11.7 million for the six months ended June 30, 2013 and 2014, respectively.

5. Earnings Per Share

Earnings per share (“EPS”) is calculated using the two-class method required for participating securities. Series B Preferred Stock was entitled to dividends at the rate equal to that of common stock.

Undistributed earnings allocated to these participating securities are subtracted from net income in determining net income attributable to common stockholders. Net losses, if any, are not allocated to these participating securities. Basic EPS is computed by dividing net income attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. Common shares outstanding include both the common shares classified as mezzanine equity and those classified as equity.

For the calculation of diluted EPS, net income attributable to common stockholders for basic EPS is adjusted by the effect of dilutive securities, including awards under stock-based payment arrangements. Diluted EPS attributable to common stockholders is computed by dividing net income attributable to common stockholders by the weighted-average number of fully diluted common shares outstanding during the period.

The following tables reconcile the numerator and denominator used in the calculation of basic and diluted EPS for the six months ended June 30, 2013 and 2014 (in thousands except share and per share amounts):

 

     Six Months Ended June 30,  
             2013                      2014          

Numerator

     

Net income attributable to AAC Holdings, Inc.

   $ 1,638       $ 1,736   

Plus: redemption of Series B Preferred Stock deemed contribution

     1,000           

Less: Series A Preferred Unit dividends

             (203
  

 

 

    

 

 

 

Net income available to common shares

   $ 2,638       $ 1,533   
  

 

 

    

 

 

 

Denominator

     

Weighted-average shares outstanding – basic

     8,671,942         9,510,427   

Dilutive securities

     62,992         33,993   
  

 

 

    

 

 

 

Weighted-average shares outstanding – diluted

     8,734,934         9,544,420   
  

 

 

    

 

 

 

Basic earnings per share

   $ 0.30       $ 0.16   

Diluted earnings per share

   $ 0.30       $ 0.16   

The Company has included common stock that is classified as mezzanine equity in the denominator for both basic and diluted EPS calculations in 2013 and 2014.

 

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6. Accounts Receivable and Allowance for Doubtful Accounts

A summary of activity in the Company’s allowance for doubtful accounts is as follows (in thousands):

 

Balance at December 31, 2013

   $ 13,320   

Additions charged to provision for doubtful accounts

     6,288   

Accounts written off, net of recoveries

     (2,434
  

 

 

 

Balance at June 30, 2014

   $ 17,174   
  

 

 

 

For the six months ended June 30, 2013, approximately 12.3% of the Company’s revenues were reimbursed by Blue Cross Blue Shield of California; 12.1% by Aetna; and 10.3% by United Behavioral Health. No other payor accounted for more than 10% of revenue reimbursements for the six months ended June 30, 2013.

For the six months ended June 30, 2014, approximately 14.5% of the Company’s revenues were reimbursed by Anthem Blue Cross Blue Shield of Colorado; 12.5% by Blue Cross Blue Shield of California; 12.3% by Aetna; and 10.4% by Blue Cross Blue Shield of Texas. No other payor accounted for more than 10% of revenue reimbursements for the six months ended June 30, 2014.

7. Notes and Other Receivables – Related Party

The Company had a note receivable from the Company’s President which totaled $250,000 as of December 31, 2013. The note was non-interest bearing and there were no payment terms or a maturity date associated with this note. The outstanding balance was repaid in full in April 2014 in connection with the BHR Acquisition. The Company also has other receivables from the Company’s CEO and the Company’s President totaling approximately $98,000 and $390,000, respectively, as of June 30, 2014. In March 2014, both parties agreed these receivables would be repaid prior to the IPO of the Company, which is expected to occur in 2014. All amounts due from the Company’s CEO and President are classified as current assets in notes and other receivables—related party in the condensed consolidated balance sheets.

8. Property and Equipment, net

Property and equipment consisted of the following (in thousands):

 

     December 31,
2013
    June 30,
2014
 

Computer equipment and software

   $ 2,267      $ 3,532   

Furniture and fixtures

     4,212        4,209   

Vehicles

     835        835   

Equipment under capital lease

     1,163        1,448   

Leasehold improvements

     3,099        3,185   

Construction in progress

     8,718        13,393   

Building

     17,918        20,854   

Land

     2,538        2,538   
  

 

 

   

 

 

 

Total property and equipment

     40,750        49,994   

Less accumulated depreciation and amortization

     (3,742     (5,683
  

 

 

   

 

 

 
   $ 37,008      $ 44,311   
  

 

 

   

 

 

 

 

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Acquired Property

In May 2013, the Company acquired a vacant facility located in Riverview, Florida (just outside of Tampa, Florida) for a purchase price of $5.8 million. The Company funded the purchase price as follows: $1.6 million from cash on hand and $3.6 million proceeds from a new bank loan with an existing lender. In addition, a $0.6 million deposit was previously funded by the Company in March 2013.

9. Goodwill and Intangible Assets

The Company’s business comprises a single reporting unit for impairment test purposes. For the purposes of these analyses, the Company’s estimates of fair value are based on the income approach, which estimates the fair value of the Company based on its future discounted cash flows. In addition to the annual impairment reviews, impairment reviews are performed whenever circumstances indicate a possible impairment may exist. The Company performed its most recent goodwill impairment testing as of December 31, 2013 and did not incur an impairment charge. The Company’s goodwill balance was $10.9 million as of December 31, 2013 and $12.7 million as of June 30, 2014. The $1.8 million increase in goodwill relates to the CRMS Acquisition discussed in Note 3.

Other identifiable intangible assets, their assigned and related accumulated amortization consisted of the following as of December 31, 2013 and June 30, 2014 (in thousands):

 

     Gross Carrying Value      Accumulated Amortization  
     December 31,
2013
     June 30,
2014
     December 31,
2013
     June 30,
2014
 

Trademarks and marketing intangibles

   $ 2,682       $ 2,682       $ 358       $ 491   

Non-compete agreements

     1,257         1,257         335         461   

Other

     271         271         21         49   
  

 

 

    

 

 

    

 

 

    

 

 

 
   $ 4,210       $ 4,210       $ 714       $ 1,001   
  

 

 

    

 

 

    

 

 

    

 

 

 

Changes to the carrying value of identifiable intangible assets during the six months ended June 30, 2014 were as follows (in thousands):

 

Balance at December 31, 2013

     3,496   

Amortization expense

     (287
  

 

 

 

Balance at June 30, 2014

   $ 3,209   
  

 

 

 

 

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10. Notes Payable and Revolving Line of Credit

A summary of the Company’s debt obligations, net of unamortized discounts, is as follows (in thousands):

 

     December 31,
2013
    June 30,
2014
 

Non-related party debt:

    

Revolving line of credit

   $ 12,550      $ 13,050   

Real estate debt

     21,548        26,752   

Acquisition-related debt

     1,500          

Asset purchases

     1,203        982   

Subordinated debt

     682        697   

Capital lease obligations

     1,022        1,146   
  

 

 

   

 

 

 

Total non-related party debt

     38,505        42,627   

Less current portion

     (15,164     (17,406
  

 

 

   

 

 

 

Total non-related party debt, long-term

   $ 23,341      $ 25,221   
  

 

 

   

 

 

 

Related party debt:

    

Acquisition-related debt

   $ 4,389      $ 3,985   

Subordinated debt

     181        182   
  

 

 

   

 

 

 

Total related party debt

     4,570        4,167   

Less current portion

     (795     (791
  

 

 

   

 

 

 

Total related party debt, long-term

   $ 3,775      $ 3,376   
  

 

 

   

 

 

 

Revolving Line of Credit

In August 2011, the Company entered into a revolving line of credit (the “Revolving Line”) with a financial institution expiring on August 15, 2013. During the second quarter of 2013, the Revolving Line was amended to extend the maturity date to April 1, 2015 and to increase the maximum borrowing limit to the lesser of (i) $20 million or (ii) 70% of the Company’s eligible accounts receivable, subject to adjustment if the aggregate of all returns, rebates, discounts, credits and allowances for the immediately preceding three months is less than 15% of the Company’s gross revenues for such period. The amended Revolving Line bears interest at one-month LIBOR, as defined in the agreement, plus 2.5% per annum (2.75% and 3.15% as of December 31, 2013 and June 30, 2014, respectively). Interest is payable monthly and is calculated on a 360 day year.

In August 2013, the Company amended the Revolving Line’s borrowing base to permit borrowings up to the lesser of (i) $20 million or (ii) 80% of the Company’s eligible accounts receivable at any time prior to February 1, 2014, and 70% of the Company’s eligible accounts receivable at any time on or after February 1, 2014, subject to adjustment if the aggregate of all returns, rebates, discounts, credits and allowances for the immediately preceding three months is less than 8% of the Company’s gross revenues for such period. The Revolving Line is secured by the Company’s accounts receivable, deposit accounts and other rights to payment, inventory, and equipment, and is guaranteed jointly and severally by all of the Company’s subsidiaries that have significant operations and/or assets and the Company’s CEO and President. The outstanding balance under the Revolving Line was $12.6 million and $13.1 million as of December 31, 2013 and June 30, 2014, respectively. The maximum unused available credit under the amended Revolving Line as of June 30, 2014 was $1.3 million based upon borrowing base restrictions.

The Revolving Line, as amended, required the Company to maintain a tangible net worth ratio not greater than 2.50 to 1.00, a fixed charge coverage ratio not less than 1.25 to 1.00, and net income of at least

 

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$1.00, all determined as of each quarter end. The Revolving Line limited capital expenditures to $0.1 million in each fiscal year unless approved by the financial institution, limits additional borrowing to $50,000 during the term of the agreement unless approved by the financial institution, limits operating lease expense to $0.1 million in each fiscal year and prohibited the payment of dividends in cash or stock. The Revolving Line also contained a cross-default clause linking a default under the Revolving Line to the occurrence of a default by the Company under any other debt agreement, material lease commitment, contract, instrument or obligation.

The Company was not in compliance with certain financial covenants contained in the Revolving Line as of December 31, 2013 and March 31, 2014. Additionally, the Company’s expenditures for capital expenditures, total operating leases and the incurring of additional indebtedness exceeded the limits specified in the Revolving Line for the year ended December 31, 2013.

These covenant violations created a cross-default with the Greenhouse Real Estate, Concorde Real Estate and Academy Real Estate debt agreements with the same lender, but for which the Company obtained waivers.

On April 15, 2014, the Revolving Line was amended and restated and included a waiver for the noncompliance of the financial covenants and negative covenants described in the preceding paragraphs.

On April 15, 2014, the Company entered into a Second Amended and Restated Credit Facility (the “Credit Facility”) with Wells Fargo Bank, National Association (the “Agent”). The Credit Facility makes available to the Company a $15.0 million revolving line of credit, subject to borrowing base limitations (the “Amended Revolving Line”), and amended and restated two existing term loans in the outstanding principal amounts of $0.6 million (“Term Loan A”) and $1.5 million (“Term Loan B”). In June 2014, the Company repaid in full the $1.5 million outstanding balance of Term Loan B.

The Amended Revolving Line bears interest at one-month LIBOR, plus an applicable margin that is determined by the Company’s leverage ratio, as defined by the agreement, at the end of each quarter. A quarter-end leverage ratio of 4.75 to 1.00 or above results in an applicable margin of 3.00%, a ratio below 4.75 to 1.00 and equal to or above 4.00 to 1.00 results in an applicable margin of 2.75%, and a ratio below 4.00 to 1.00 results in an applicable margin of 2.50%. Term Loan A bears interest at LIBOR plus 3.15%. The borrowing base for the Amended Revolving Line is 70% of the Company’s eligible accounts receivable and was established with the understanding that the aggregate of all returns, rebates, discounts, credits and allowances, exclusive of the initial adjustment to record net revenues at the time of billing, for the immediately preceding three months will be less than 20% of gross revenues for such period (up from the previous restriction of 8%). If the aggregate of all returns, rebates, discounts, credits and allowances, exclusive of the initial adjustment to record net revenues at the time of billing, for the immediately preceding three months is greater than 20% of gross revenues for such period, or if there exists any other matters, events, conditions or contingencies that the Agent reasonably believes may affect payment of any portion of the Company’s accounts, the Agent may reduce the borrowing base from 70% of the Company’s eligible accounts receivable to a lower percentage.

The amendment and restatement removed the previous covenants which required the Company to maintain a minimum tangible net worth ratio and minimum net income. The Credit Facility requires the Company to achieve minimum net revenues and adjusted EBITDA for each quarter, determined on a rolling four quarters basis, of no less than 85% of net revenues and adjusted EBITDA for the immediately preceding four quarters. The Credit Facility generally defines adjusted EBITDA as consolidated net income plus (i) interest expense, (ii) depreciation and amortization expense, (iii) tax expense, (iv) non-cash stock compensation, (v) one-time legal and restructuring costs incurred in 2014 in connection with the Company’s private placement, the reorganization transactions (see Note 3), the BHR preferred equity transactions (see Note 3), and an IPO of the Company in an

 

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amount not to exceed $2.5 million, (vi) one-time legal, accounting and other transaction costs incurred in connection with a permitted acquisition in 2014 or in any subsequent fiscal year in an aggregate amount not to exceed $0.2 million in any fiscal year, (vii) one-time settlement costs paid on or about April 9, 2014, in connection with certain wage and settlement charges in California in an amount not to exceed $2.5 million, (viii) one-time restructuring costs incurred in 2013 in connection with the closing of the Leading Edge operations and the consolidation of call centers in an amount not to exceed $0.8 million, and (ix) to the extent approved by Wells Fargo Bank in writing, other one-time and non-recurring charges.

The Credit Facility also requires the Company to achieve a fixed charge coverage ratio of not less than 1.25 to 1.00 for each quarter, determined on a rolling four quarter basis, and achieve a liquidity covenant (as described by the agreement) of no less than $9.0 million on and as of July 14, 2014. In connection with the June 2014 prepayment of Term Loan B, the parties to the Credit Facility agreed to permanently waive this liquidity covenant. Finally, the Credit Facility includes a maximum leverage ratio covenant, whereby the ratio of funded debt to EBITDA must not be greater than the ratios set forth below on a rolling four quarter basis:

 

Fiscal Quarter End

   Maximum Leverage Ratio  

June 30, 2014

     5.00:1.00   

September 30, 2014

     4.75:1.00   

December 31, 2014 and thereafter

     3.75:1.00   

The Credit Facility limits aggregate capital expenditures (as defined by the agreement and which exclude, among other items, capital expenditures made by BHR and its subsidiaries that are funded with debt permitted under the agreement or proceeds from this offering and permitted acquisitions under the agreement) to $3.0 million in each fiscal year and limits capital lease debt and other purchase money debt to $2.3 million.

The Credit Facility also contains customary events of default including, but not limited to, failure to make payments under the Credit Facility, materially incorrect representations, breaches of covenants (subject to a 20 day cure period in the case of certain covenants), cross-default to any other material indebtedness, bankruptcy and insolvency events, change of control, and the failure of guarantees or security to remain in full force and effect.

The Credit Facility, as amended in June 2014, also provides for standby letters of credit in an aggregate undrawn amount not to exceed $3.0 million, and in July 2014 Wells Fargo issued on the Company’s behalf an irrevocable standby letter of credit in the amount of $700,000.

Capital Lease

In March 2014, the Company entered into a $0.3 million capital lease with a third party leasing company of lab equipment. The capital lease bears interest at 5.2% per annum and requires 60 monthly payments of $5,368. At the end of the lease term, the Company may buy the equipment for $1. The outstanding balance under this capital lease at June 30, 2014 was $0.3 million.

Greenhouse Real Estate, LLC

Greenhouse Real Estate, LLC (the “Borrower”) entered into a $13.2 million construction loan facility (the “Construction Facility”) with a financial institution on October 8, 2013 to refinance existing debt related to a 70-bed facility and to fund the construction of an additional 60 beds at this facility located in Grand Prairie, Texas. Monthly draws may be made against the Construction Facility based on actual construction costs incurred.

 

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Interest, which is payable monthly, is calculated based on a 360 day year and accrues at the Company’s option of either (i) one-month LIBOR (as defined in the agreement) plus 3.0%, with such rate fixed until the next monthly reset date, or (ii) floating at one-month LIBOR (as defined in the agreement) plus 3.0%. In the event that the Company elects the floating option for either two consecutive periods or a total of three periods, the floating rate increases by 0.25%. At December 31, 2013, the outstanding Construction Facility was $8.7 million and the interest rate was 3.25%. At June 30, 2014, the outstanding Construction Facility was $12.5 million and the interest rate was 3.25%. The Construction Facility matures on October 31, 2014.

At the Borrower’s option, the Construction Facility can be converted to a permanent term loan with an extended maturity of October 31, 2019 provided (i) there is no default, (ii) the construction is 100% complete, (iii) there shall have occurred no material adverse change, as determined by the financial institution in its sole discretion, in the financial condition of the Borrower and (iv) other terms and conditions are satisfied. The maximum amount that may be converted is 65% of the appraised value at the time of the conversion. If at the time of the conversion the loan value exceeds the 65% loan-to-value ratio, the Borrower is permitted to make principal payments to reduce the loan-to-value to the 65% threshold. In the event the Borrower does not elect to or is unable to convert the Construction Facility to a permanent term loan, the Borrower is required to pay an exit fee equal to 3.0% of the then outstanding balance. Principal payments at the time of the conversion are to be calculated based on a 15-year amortization schedule, and monthly principal and interest payments are required with a balloon payment at maturity. The permanent loan will bear interest at one-month LIBOR (as defined in the agreement) plus 2.5%, with such rate fixed for that monthly interest period. Because the permanent loan contains contingencies other than the completion of the construction, the Company has classified the entire $8.7 million outstanding at December 31, 2013 as current. In August 2014, the construction loan converted to a permanent loan requiring monthly principal payments of $70,778 plus interest and a balloon payment of $8.5 million at maturity. The classification of the outstanding balance as of June 30, 2014 between current and long term is based on the terms of the permanent loan and resulted in a reclassification of $11.7 million to long term.

The Construction Facility is secured by a deed of trust and the assignment of certain leases and rents and is guaranteed by the Company and the CEO and President of the Company. The Borrower is required to maintain a minimum debt service coverage ratio of 1.25 to 1.00. The note also contains a cross-default clause linking a default under the Greenhouse Real Estate loan to the occurrence of a default by any guarantor or an affiliate of a guarantor with respect to any other indebtedness.

Behavioral Healthcare Realty, LLC

As discussed in Note 3, the Company assumed a $1.8 million term loan in conjunction with the acquisition of Behavioral Healthcare Realty, LLC. The Company refinanced this loan with a financial institution and the new loan requires monthly principal payments of $35,855 plus interest at 5.0% with a balloon payment of $1.4 million due at maturity in April 2015. In the event of an IPO prior to April 2015, this loan is required to be repaid in full with proceeds from the IPO.

11. Mezzanine Equity

Share Imperfections

In 2008, preferred shares were issued by the previous board of directors of AAC prior to the timely filing of a Certificate of Designation with the Secretary of State of Nevada. Additionally in 2008, certain common shares were issued by the previous board of directors of AAC which were in excess of the number of shares duly authorized by AAC’s Articles of Incorporation. AAC has classified these preferred and common shares as mezzanine equity at the original purchase price in the condensed consolidated balance sheets because they do not meet the definition of permanent equity as a result of these legal imperfections.

 

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To address these issues, in April 2014, the Company conducted the Private Share Exchange with certain stockholders of AAC, whereby holders representing 93.6% of the outstanding shares of common stock of AAC, which were classified in both Mezzanine Equity and Stockholders’ Equity, exchanged their shares on a one-for-one basis for shares of the Company’s common stock. The Private Share Exchange was conditioned upon, among other things, a release by each exchanging stockholder of any and all potential claims arising from corporate actions that were not conducted in compliance with Nevada law.

Statement of Mezzanine Equity

Changes to mezzanine amounts during the six months ended June 30, 2014 were as follows (dollars in thousands):

 

     Noncontrolling Interest     American Addiction
Centers, Inc.
 
     BHR Series A Preferred     Common Shares  
     Units     Amount     Shares     Amount  

Balance at December 31, 2013

     28.0      $ 1,400        7,281,283      $ 10,442   

Issuance of BHR Series A Preferred Units

     8.5        425                 

Stock redemption

     (36.5     (1,825              

Issuance of Series A Preferred Units to Alcentra

     160        7,782                 

Shares acquired by the Company

                   (7,244,109     (10,389
  

 

 

   

 

 

   

 

 

   

 

 

 

Balance at June 30, 2014

     160      $ 7,782        37,174      $ 53   
  

 

 

   

 

 

   

 

 

   

 

 

 

In January and February of 2014, BHR sold 8.5 units of Series A Preferred Units, valued at $50,000 per unit, with proceeds to BHR of $0.4 million, net of issuance costs of $11,300. A director of the Company purchased five Series A Preferred Units for $0.3 million at $50,000 per unit. After the sale, 36.5 Series A Preferred Units were outstanding totaling approximately $1.8 million. On April 15, 2014, BHR redeemed all 36.5 outstanding Series A Preferred Units for $1.8 million. These former holders of Series A Preferred Units used the proceeds to purchase 143,017 shares of AAC common stock at $12.76 per share as part of an exempt common stock offering. A director and relative of a director of the Company received approximately $450,000 and purchased 35,385 shares of AAC common stock in connection with the redemption of nine Series A Preferred Units.

On April 15, 2014 BHR sold 160 units of Series A Preferred Units, valued at $50,000 per unit, with proceeds to BHR of $7.8 million, net of issuance costs of $0.2 million. The issuance costs will be amortized over a 36 month period, the first date the holder can put the shares back to the Company. See Note 3 for a complete disclosure of the major components of this transaction and the related outstanding Series A Preferred Units.

12. Stockholders’ Equity

Common Stock

In February and March 2014, AAC received proceeds of $4.2 million, net of $12,500 in issuance costs, from the sale of 328,826 shares of its common stock at $12.76 per share, which the Company’s management determined to be fair value, in an exempt common stock offering. Included within the total shares sold in the Company’s 2014 private placement were 39,184 shares sold to directors of the Company, 7,837 shares sold to the Company’s General Counsel and Secretary, 3,918 shares sold the Company’s COO and 1,959 shares sold to one of the Company’s Vice Presidents. The share price was based, in part, on an independent valuation analysis obtained in December 2013 independent valuation analysis.

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

 

On April 11, 2014, AAC granted 49,496 shares of restricted common stock to its General Counsel and Secretary under the Company’s 2007 Stock Incentive Plan (the “Incentive Plan”), of which 24,748 shares vested immediately with the remaining 24,748 shares vesting on April 10, 2015. The fair value on the award date was $12.76 per share, as determined by the Company’s management. As a result of the award, AAC recorded $0.3 million of compensation expense, $0.2 million of additional compensation expense to satisfy the employee’s personal tax obligation related to the vesting of the grant during the second quarter of 2014, and $0.3 million ratably over the one-year vesting period. Additionally, on April 11, 2014, AAC granted 3,019 shares of its common stock to a non-executive employee. AAC recorded $39,000 of compensation expense and $30,000 of additional compensation expense to satisfy the employee’s personal tax obligation related to the stock grant during the second quarter of 2014.

On April 17, 2014, AAC redeemed a total of 9,113 shares of its common stock at $12.76 per share, which the Company’s management estimates to be fair value, for an aggregate redemption price of $0.1 million.

In connection with the issuance of subordinated notes in 2012, AAC issued detachable warrants to the lenders to purchase a total of 71,705 shares of common stock at $1.00 per share. The warrants were exercisable at any time up to their expiration on March 31, 2022. In March 2014, 67,931 of the outstanding warrants were exercised and a total of 67,931 shares of AAC common stock was issued to the exercising warrant holders, including 15,095 shares to a Company director. In April 2014, the remaining outstanding warrants for the purchase of 3,774 shares of AAC common stock were exercised.

In connection with the 2013 exempt offering of AAC common stock, a Company employee subscribed for 12,150 shares of common stock at $8.23 per share, which the Company’s management estimated to be fair value. As consideration for the shares, the employee issued to the Company a subscription note receivable in the amount of $0.1 million. The Company is forgiving this subscription note receivable over a 12-month period ending on July 1, 2014. During the six month period ended June 30, 2014, the Company recorded $50,000 in compensation expense related to this forgiveness.

13. Stock Based Compensation Plans

In March 2014, AAC granted 3,713 shares of fully vested common stock to each of its five non-employee directors. The Company recognized $0.2 million of compensation expense in the first quarter of 2014 as a result of these grants. The fair value on the award date was $12.76 per share, as estimated by the Company’s management.

On April 11, 2014, AAC granted a total of 52,515 shares of restricted common stock to two employees as discussed in Note 12.

A summary of share activity under the Incentive Plan is set forth below:

 

     Shares     Weighted-
average Grant
Date Fair Value
 

Unvested at December 31, 2013

     69,612      $ 10.19   

Granted

     71,080        12.76   

Vested

     (92,739     11.47   
  

 

 

   

Unvested at June 30, 2014

     47,953        11.52   
  

 

 

   

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

 

14. Income Taxes

The provision for income taxes for the six months ended June 30, 2013 and 2014 reflects effective tax rates of 46.8% and 44.6%, respectively. The decrease in the effective tax rate for the six months ended June 30, 2014 compared to the six months ended June 30, 2013 was primarily attributable to an increase in the state and federal valuation allowance related to net losses of the Professional Groups offset by a decrease in permanent non-deductible tax items.

15. Commitments and Contingencies

Litigation

In April 2013, two wage and hour claims were filed against the Company in the State of California and were subsequently consolidated into a class action. In June 2013, the parties agreed to settle the substantive claims for $2.5 million during mediation. Once the settlement became probable, the Company established a $2.5 million reserve during the second quarter of 2013 for this matter. Subsequently, on April 9, 2014 and following court approval, the Company settled this matter with payment of $2.6 million. The total amount of the litigation settlement of $2.6 million is reflected in accrued liabilities at December 31, 2013.

American Addiction Centers, Inc. v. James D. Bevell, Jr.

On February 3, 2014, AAC filed an action against James D. Bevell in the U.S. District Court in the Middle District of Tennessee, alleging breach of contract and tortious interference with business practices arising out of Mr. Bevell’s breach of his non-compete agreements. Mr. Bevell is the former Chief Innovation Officer of AAC and owns 4.5% of the outstanding common stock of AAC as of June 30, 2014. AAC’s complaint seeks preliminary and permanent injunctive relief, declaratory judgment, compensatory damages, punitive damages for intentional, fraudulent, reckless or grossly negligent conduct, reasonable attorneys’ fees and costs and other legal, equitable or general relief for breach of contract and associated wrongs. On March 5, 2014, the court granted a preliminary injunction enjoining Mr. Bevell and his officers, agents, servants, employees, attorneys and all persons in active concert or participation with him from violating the non-competition and non-solicitation provisions contained in his employment agreement with AAC and in the purchase agreement related to the TSN Acquisition. The parties have engaged in preliminary discussions regarding possible settlement of this matter; however, there is no assurance that these discussions will be successful.

James D. Bevell, Jr. v. Michael Cartwright et al.

On July 16, 2014, Mr. Bevell filed an action, for which an amended complaint was filed on August 15, 2014, in the Chancery Court for the State of Tennessee in Williamson County against Michael Cartwright, Jerrod Menz, AAC Holdings, Inc., Clinical Revenue Management Services, LLC, Tina Cartwright, Victoria Menz, Behavioral Healthcare Realty, LLC and AAC. The amended complaint alleges the defendants breached fiduciary duties owed to Mr. Bevell and breached the Agreement Among Stockholders entered into in connection with the TSN Acquisition. Mr. Bevell’s amended complaint seeks rescission of the Reorganization Transactions and compensatory and punitive damages. We intend to vigorously defend these claims and believe them to be without merit. The parties have engaged in preliminary discussions regarding possible settlement of these matters; however, there is no assurance that these discussions will be successful.

 

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AAC HOLDINGS, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

 

Horizon Blue Cross Blue Shield of New Jersey v. Avee Laboratories et al.

On September 4, 2013, Horizon Blue Cross Blue Shield of New Jersey (“Horizon”) filed an amended complaint in the Superior Court of New Jersey against several defendants, including Leading Edge Recovery Center, LLC, one of the Company’s subsidiaries. Leading Edge Recovery Center, LLC formerly operated a drug and alcohol treatment facility in New Jersey. Horizon alleges the defendants submitted and caused others to submit unnecessary drug tests in violation of New Jersey law and is seeking recovery for monetary and treble damages. The Company is vigorously defending these claims and believes them to be without merit. The Company cannot provide any assurance that it will prevail in this matter, nor can it reasonably estimate its potential liability if there is an adverse outcome. Further, the Company has made a demand for indemnification upon James D. Bevell for the portion of these claims relating to the period prior to the TSN Acquisition. The Company cannot provide any assurance that it will prevail in its indemnity claim with Mr. Bevell for any portion of these claims.

Other

The Company is aware of various other legal matters arising in the ordinary course of business. To cover these types of claims, the Company maintains insurance it believes to be sufficient for its operations, although, some claims may potentially exceed the scope of coverage in effect. Plaintiffs in these matters may request punitive or other damages that may not be covered by insurance. After taking into consideration the evaluation of such matters by the Company’s legal counsel, the Company’s management believes the outcome of these matters will not have a material impact on the Company’s consolidated financial position, results of operations and cash flows.

16. Subsequent Events

The Company has evaluated subsequent events through August 15, 2014. In addition to the subsequent events discussed in Notes 10 and 15, the following events have occurred subsequent to June 30, 2014.

In July 2014, the Company entered into two interest rate swap agreements to mitigate its exposure to interest rate risks. The interest rate swap agreements have initial notional amounts of $13.2 million and $8.9 million which fix the interest rates over the life of interest rate swap agreement at 4.62% and 4.16%, respectively.

 

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INDEPENDENT AUDITOR’S REPORT

Board of Directors

AJG Solutions, Inc. and B&B Holdings Intl LLC

Ft. Lauderdale, Florida

We have audited the accompanying combined balance sheets of AJG Solutions, Inc. and B&B Holdings Intl LLC (collectively the “Company”) as of December 31, 2011 and August 31, 2012, and the related combined statements of income and stockholders’ / members’ equity, and cash flows for the year ended December 31, 2011 and the eight months ended August 31, 2012. These combined financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these combined financial statements based on our audits.

We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the combined financial statements are free of material misstatement. An audit includes consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the combined financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall combined financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the combined financial statements referred to above present fairly, in all material respects, the combined financial position of AJG Solutions, Inc. and B&B Holdings Intl LLC at December 31, 2011 and August 31, 2012, and the combined results of its operations and its cash flows for the year ended December 31, 2011 and the eight months ended August 31, 2012 in conformity with accounting principles generally accepted in the United States of America.

/s/ BDO USA, LLP

Nashville, Tennessee

June 20, 2013

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

COMBINED BALANCE SHEETS

 

     December 31,
2011
     August 31,
2012
 

Assets

     

Current assets:

     

Cash and cash equivalents

   $ 769,235       $ 1,876,903   

Accounts receivable, net of allowances

     2,909,891         5,460,310   

Prepaid expenses and other

     74,977         77,786   
  

 

 

    

 

 

 

Total current assets

     3,754,103         7,414,999   

Property and equipment, net

     244,637         453,447   

Intangibles

     75,000         75,000   

Other assets

     38,174         280,424   
  

 

 

    

 

 

 

Total assets

   $ 4,111,914       $ 8,223,870   
  

 

 

    

 

 

 

Liabilities and Stockholders’ / Members’ Equity

     

Current liabilities

     

Accounts payable

   $ 251,404       $ 555,529   

Accrued liabilities

     678,108         796,790   

Capital lease obligations, current portion

     26,942         42,759   

Notes payable

     127,646         76,521   

Notes payable—related party

             150,030   
  

 

 

    

 

 

 

Total current liabilities

     1,084,100         1,621,629   

Long term liabilities

     

Capital lease obligations, net of current portion

     61,344         56,326   
  

 

 

    

 

 

 

Total liabilities

     1,145,444         1,677,955   

Commitments and contingencies (Note 9)

     

Stockholders’ / members’ equity (Note 8)

     2,966,470         6,545,915   
  

 

 

    

 

 

 

Total liabilities and stockholders’ / members’ equity

   $ 4,111,914       $ 8,223,870   
  

 

 

    

 

 

 

See accompanying notes to combined financial statements.

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

COMBINED STATEMENTS OF INCOME AND SHAREHOLDERS’ / MEMBERS’ EQUITY

 

     Year Ended
December 31,
2011
    Eight Months
Ended August 31,
2012
 

Revenues

   $ 15,041,250      $ 18,477,207   

Operating expenses

    

Client related services

     3,610,961        5,214,276   

Salaries, wages, and benefits

     4,600,135        4,653,879   

Professional fees

     1,709,804        1,325,426   

Rents and leases

     241,947        251,638   

Advertising and marketing

     593,375        541,369   

Other operating expenses

     1,189,482        1,536,437   

Provision for doubtful accounts

     205,653        646,308   

Depreciation and amortization

     72,781        81,973   
  

 

 

   

 

 

 

Total operating expenses

     12,224,138        14,251,306   
  

 

 

   

 

 

 

Income from operations

     2,817,112        4,225,901   
  

 

 

   

 

 

 

Other income, net

    

Interest income (expense), net

     (31,132     (21,908
  

 

 

   

 

 

 

Total other income (expense), net

     (31,132     (21,908
  

 

 

   

 

 

 

Income before income tax expense

     2,785,980        4,203,993   

State income tax expense

     4,960        1,000   
  

 

 

   

 

 

 

Net income

   $ 2,781,020      $ 4,202,993   

Stockholders’ / members’ equity, beginning of the period

     509,726        2,966,470   

Distributions

     (324,276     (623,548
  

 

 

   

 

 

 

Stockholders’ / members’ equity, end of the period

   $ 2,966,470      $ 6,545,915   
  

 

 

   

 

 

 

See accompanying notes to combined financial statements.

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

COMBINED STATEMENTS OF CASH FLOWS

 

     Year Ended
December 31,
2011
    Eight Months
Ended August 31,
2012
 

Cash flows from operating activities:

    

Net income

   $ 2,781,020      $ 4,202,993   

Adjustments to reconcile net income to net cash provided by operating activities:

    

Bad debt expense

     205,653        646,308   

Depreciation and amortization

     72,781        81,973   

Changes in assets and liabilities:

    

Accounts receivable

     (2,274,696     (3,196,727

Prepaid expenses and other assets

     (31,379     (2,810

Accounts payable

     (16,811     304,126   

Accrued liabilities

     565,488        119,984   
  

 

 

   

 

 

 

Net cash provided by operating activities

     1,302,056        2,155,847   
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Purchase of property and equipment

     (103,159     (249,061

Purchase of other assets

     (16,941     (242,250
  

 

 

   

 

 

 

Net cash used in investing activities

     (120,100     (491,311
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Payments on capital lease obligations

     (36,649     (30,923

Proceeds from notes payable

     351,103        117,935   

Repayment of notes payable

     (443,994     (170,362

Proceeds from note payable—related party

            150,030   

Distributions

     (324,276     (623,548
  

 

 

   

 

 

 

Net cash used in financing activities

     (453,816     (556,868
  

 

 

   

 

 

 

Net increase in cash and cash equivalents

     728,140        1,107,668   

Cash and cash equivalents, beginning of year

     41,095        769,235   
  

 

 

   

 

 

 

Cash and cash equivalents, end of period

   $ 769,235      $ 1,876,903   
  

 

 

   

 

 

 

Supplemental disclosures of cash flow information:

    

Non-cash transactions:

    

Property and equipment acquired via capital leases

   $ 77,851      $ 41,722   
  

 

 

   

 

 

 

Cash and cash equivalents paid for:

    

Interest

   $ 35,528      $ 20,447   
  

 

 

   

 

 

 

Income taxes

   $ 4,960      $ 1,000   
  

 

 

   

 

 

 

See accompanying notes to combined financial statements.

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

NOTES TO COMBINED FINANCIAL STATEMENTS

1. Description of Business

AJG Solutions, Inc., a Florida corporation (“AJG”), was incorporated as a Subchapter S corporation in December 2005. AJG, headquartered in Ft. Lauderdale, Florida, provides referral services for addiction rehabilitation services and centers.

B&B Holdings Intl LLC (“B&B”), a Florida limited liability company, was organized in February 2010. B&B, headquartered in Ft. Lauderdale, Florida, provides addiction rehabilitation services through centers in Florida and New Jersey.

On August 31, 2012, American Addiction Centers, Inc. (“AAC”) acquired certain assets of AJG and the equity of B&B. AJG and B&B were both jointly owned by two individuals. AAC intends for the acquisition to expand the scope of its services geographically and gain synergies in obtaining leads for new clients. AAC, headquartered in Brentwood, Tennessee, develops and operates substance abuse, addiction and chemical dependency, mental disorder, weight loss and other behavioral treatment centers.

2. Basis of Presentation

Principles of Combination

The combined financial statements presented herein represent the combination of AJG and B&B (collectively the “Company”) due to the common ownership between the two entities. In addition, as a result of the acquisition of the Company on August 31, 2012 by AAC, the 2012 financial statements are presented as of August 31, 2012 and the eight months then ended. Effective September 1, 2012, future operations of the Company will be reported within AAC’s consolidated financial statements.

The accompanying combined financial statements include the accounts of AJG, B&B and their wholly owned subsidiaries which include Leading Edge Recovery Center, LLC, Hamilton Medically Assisted Treatment Associates, LLC, The Heights Supportive Housing, LLC, Singer Island Recovery Center, LLC, and Island Supportive Housing, LLC.

All significant intercompany accounts and transactions within the Company have been eliminated in combination.

3. Summary of Significant Accounting Policies

Use of Estimates

The preparation of combined financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues, and expenses at the date and for the periods that the combined financial statements are prepared. On an ongoing basis, the Company evaluates its estimates, including those related to insurance adjustments, provisions for doubtful accounts, intangible assets, and long-lived assets. The Company bases its estimates on historical experience and on various other assumptions that it believes to be reasonable under the circumstances. Actual results could materially differ from those estimates.

Cash and Cash Equivalents

The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents.

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

NOTES TO COMBINED FINANCIAL STATEMENTS

 

Accounts Receivable and Allowance for Doubtful Accounts

Accounts receivable are reported net of an allowance for doubtful accounts, which is management’s best estimate of potential credit losses. The Company’s allowance for doubtful accounts is based on historical experience, but management also takes into consideration the age of the accounts, creditworthiness and current economic trends when evaluating the adequacy of the allowance for doubtful accounts.

The Company does not believe that there are any significant concentrations of revenues from any particular payor that would subject it to any significant credit risks in the collection of its accounts receivable.

Property and Equipment

Property and equipment are stated at cost, net of accumulated depreciation and amortization. Expenditures for maintenance and repairs are charged to expense as incurred. Leasehold improvements are amortized over their estimated useful lives or the remaining lease period, whichever is less. Depreciation is provided by use of the straight-line method over the estimated useful lives of the assets.

Estimated useful lives were as follows:

 

     Range of Lives  

Computer software and equipment

     3–5 years   

Furniture, fixtures, and equipment

     5–7 years   

Vehicles

     5 years   

Leasehold improvements

     life of the asset or lease, whichever is less   

Intangibles

Intangible assets at December 31, 2011 and August 31, 2012 represented a trademark and website domain acquired for $75,000 in November 2010. The life of such intangibles was deemed to be indefinite. Indefinite intangibles are tested annually for impairment, or when events or changes in circumstances indicate the potential for impairment.

Long-Lived Asset Impairment

Accounting Standards Codification (“ASC”) 360 addresses financial accounting and reporting requirements for the impairment or disposal of long-lived assets. Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net undiscounted cash flows expected to be generated by the asset. Impairment is measured by the amount by which the carrying value of the assets exceeds the fair value of the assets. The Company did not identify any indicators of impairment as of December 31, 2011 and August 31, 2012.

Revenues

The Company provides services to its clients in both inpatient and outpatient treatment settings. Client service revenues are recognized when services are performed. Client service revenues are recorded at established billing rates less contractual adjustments. Contractual adjustments are recorded to state client service revenues at the amount expected to be collected for the service provided based on amounts due at contractually determined rates or expected amounts based on historic adjustments for out-of-network services not under contract.

Prior to admission, each client’s insurance is verified and the client self-pay amount is determined. The client self-pay portion is generally collected upon admission. In some instances, clients will pay out-of-pocket as

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

NOTES TO COMBINED FINANCIAL STATEMENTS

 

services are provided or will make a deposit and negotiate the remaining payments as part of the services. The client service revenues are deferred and recognized over the period the services will be provided. If a client leaves prior to utilizing the total payment, the balance is accounted for as a liability and is included in accrued liabilities in the accompanying consolidated balance sheets until refunded.

Referral Service Revenues

The Company provides referral services for addiction rehabilitation services and centers. Services are billed using either a flat monthly rate or on a per referral basis. Revenues are recorded as the services are performed. Payments received prior to the services being performed are deferred and recognized over the period in which the service is provided.

Advertising Expenses

Advertising costs are expensed as the related activity occurs.

Income Taxes

The Company’s stockholders’ have elected to be taxed under sections of the federal income tax laws which provided that, in lieu of corporation income taxes, the stockholders separately account for their pro rata shares of the Company’s items in income, deductions, losses and credits. Therefore, these statements do not include any provision for Federal corporate income taxes.

The Company has no uncertain tax positions. The Company’s practice is to recognize interest and/or penalties related to income tax matters in income tax expense. For the year ended December 31, 2011 and the eight months ended August 31, 2012, the Company had no accrued interest or penalties related to income tax matters in income tax expense.

The Company is no longer subject to federal income tax examinations for years prior to fiscal 2008. The Company is subject to examination by various State Franchise Tax Boards for fiscal years after 2007. There are no current tax examinations in progress.

Fair Value Measurements

ASC 820 Fair Value Measurements and Disclosures (“ASC 820”) establishes a framework for measuring fair value and requires enhanced disclosures about fair value measurements. ASC 820 clarifies that fair value is an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants.

ASC 820 requires disclosure about how fair value is determined for assets and liabilities and establishes a hierarchy for which these assets and liabilities must be grouped, based on significant levels of inputs as follows: Level 1—quoted prices in active markets for identical assets or liabilities; Level 2—quoted prices in active markets for similar assets and liabilities and inputs that are observable for the asset or liability; or Level 3—unobservable inputs for the asset or liability, such as discounted cash flow models or valuations. The determination of where assets and liabilities fall within this hierarchy is based upon the lowest level of input that is significant to the fair value measurement.

Concentration of Credit Risk

Cash and cash equivalents are maintained at financial institutions and, at times, balances may exceed federally insured limits. The Company has never experienced any losses related to these balances. All of the

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

NOTES TO COMBINED FINANCIAL STATEMENTS

 

Company’s cash balances were fully insured at December 31, 2011 and August 31, 2012 as a result of a temporary federal program in effect from December 31, 2010 through December 31, 2012. Under the program, there is no limit to the amount of insurance for eligible accounts.

4. Accounts Receivable, net

Accounts receivable consists of the following:

 

     December 31,
2011
    August 31,
2012
 

Accounts receivable

   $ 6,263,745      $ 8,279,597   

Less allowance for doubtful accounts

     (3,353,854     (2,819,287
  

 

 

   

 

 

 
   $ 2,909,891      $ 5,460,310   
  

 

 

   

 

 

 

5. Property and Equipment, net

Property and equipment consists of the following:

 

     December 31,
2011
    August 31,
2012
 

Computer software and equipment

   $ 112,452      $ 159,274   

Furniture, fixtures and equipment

     86,963        156,023   

Vehicles

     146,978        227,333   

Leasehold improvements

            77,879   
  

 

 

   

 

 

 

Total property and equipment

     346,393        620,509   

Less accumulated depreciation and amortization

     (101,756     (167,062
  

 

 

   

 

 

 
   $ 244,637      $ 453,447   

6. Notes Payable

Asset Purchase

In June 2012, the Company entered into a $150,030 note payable agreement with a stockholder and chief executive officer of the Company. The note bears interest at 5% per annum and is payable in 12 equal monthly payments. As of August 31, 2012, $150,030 remained outstanding on the note. The proceeds of the note payable were used by the Company to make investments in two other entities. As of August 31, 2012, the $150,000 investment was recorded within other assets on the accompanying combined balance sheet.

Operating

During 2010, the Company entered into a $150,882 note payable with an individual to fund operations. Under the terms of the agreement, the note incurred an interest rate of 17% per annum and was payable in four equal monthly installments of $40,181 commencing in February 2011.

In April 2011, the Company entered into a new note agreement with the individual totaling $230,000. The $230,000 consisted of new proceeds of $150,220 and $79,780 in principal and accrued interest rolled over from the 2010 note discussed above. Under the terms of the new agreement, the note incurred interest at 15% per annum with six monthly payments commencing in June 2011 ranging from $19,663 to $63,375. As of December 31, 2011, $30,763 was outstanding on the note.

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

NOTES TO COMBINED FINANCIAL STATEMENTS

 

In March 2012, the Company entered into a $150,000 note payable with the individual above to fund operations. The $150,000 consisted of new proceeds of $117,935 and $32,065 in principal and accrued interest rolled over from the April 2011 note discussed above. Under the terms of the agreement, the note incurs interest at a rate of 15% per annum and was payable in six monthly installments of $26,105 commencing in April 2012. As of August 31, 2012, $76,521 was due under the note. The note was satisfied in full subsequent to August 31, 2012.

In January 2011, the Company entered into a verbal agreement with a third party to borrow $50,000 to fund operations. Under the terms of the agreement, the amounts were due on demand and did not incur interest. As of December 31, 2011, $8,000 was outstanding under the agreement. The obligation was satisfied in full during the eight months ended August 31, 2012.

In July 2011, the Company entered into a $150,000 note payable with a third party to fund operations. Under the terms of the agreement, the note bears an interest rate of 5.25% per annum and was payable in twelve months installments of $12,858 beginning in August 2011. The note was guaranteed by a stockholder of the Company. As of December 31, 2011, $88,883 was outstanding on the note. The note was satisfied in full during the eight months ended August 31, 2012.

7. Capital Lease Obligations

At various times through August 31, 2012, the Company entered into capital leases with third-party creditors for the purchase of vehicles which have maturity dates ranging from February 2013 to June 2016. The lease terms range from 10 to 48 months and have interest rates ranging from 0.00% to 10.5% per annum. Monthly payments range from $312 to $1,267.

As of August 31, 2012, the five year minimum payments on capital lease obligations are as follows:

 

Years ending December 31,

   Total  

Four months ended December 31, 2012:

   $ 17,639   

2013

     42,785   

2014

     28,896   

2015

     17,930   

2016

     2,705   
  

 

 

 

Total minimum lease payments

     109,955   

Less: amount representing interest

     (10,870
  

 

 

 

Present value of minimum lease payments

     99,085   

Less: current portion

     (42,759
  

 

 

 

Obligation under capital lease, long term

   $ 56,326   
  

 

 

 

As of December 31, 2011, the gross carrying value and accumulated amortization of assets acquired under capital leases was $146,978 and $27,942, respectively. As of August 31, 2012, the gross carrying value and accumulated amortization of assets acquired under capital leases was $198,700 and $54,091, respectively.

8. Stockholders’ and Members’ Equity

Common Stock—AJG

As of December 31, 2011 and August 31, 2012, AJG had 500 shares authorized and outstanding with $1 par value.

 

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AJG SOLUTIONS, INC. AND B&B HOLDINGS INTL LLC

NOTES TO COMBINED FINANCIAL STATEMENTS

 

Membership Units—B&B

As of December 31, 2011 and August 31, 2012, B&B had 100 membership units authorized and outstanding with no par value.

9. Commitments and Contingencies

Operating Leases

The Company has entered into various operating leases with third parties expiring through January 2017. Properties under operating leases mostly include space required for corporate offices, space to perform facility services and space for administrative facilities. Rent expense was $241,947 and $251,638 for the year ended December 31, 2011 and the eight months ended August 31, 2012, respectively.

The future minimum lease payments under non-cancelable operating leases with remaining terms of one or more years as of August 31, 2012 consist of the following:

 

Years ending December 31,

   Total  

Four months ended December 31, 2012

   $ 17,639   

2013

     40,251   

2014

     28,903   

2015

     17,937   

2016

     2,707   
  

 

 

 

Total

   $ 107,437   
  

 

 

 

The Company has certain leases which have escalating payment clauses. As of December 31, 2011 and August 31, 2012, the difference between actual payments under these leases and rent expense on a straight line basis was not material.

Litigation

The Company is aware of various legal matters arising in the ordinary course of business. After considering the evaluation by the Company’s legal counsel of such matters, as well as taking into consideration insurance coverage and relevant deductible levels, the Company’s management is of the opinion that the outcome of these matters will not have a material effect on the Company’s combined financial position, results from operations and cash flows as of and for the periods ended December 31, 2011 and August 31, 2012.

401(k) Plan

The Company has a qualified 401(k) savings plan (the “Plan”) which provides for eligible employees (as defined) to make voluntary contributions to the Plan. The Company makes contributions to the Plan based upon the participants’ level of participation, which is fully vested at the time of contribution. For the year ended December 31, 2011 and the eight months ended August 31, 2012, the Company contributions under this Plan were not material.

10. Subsequent Events

The Company has evaluated subsequent events through June 20, 2013, which is the date that these combined financial statements were available to be issued.

 

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INDEPENDENT AUDITOR’S REPORT

Board of Directors and Stockholders

American Addiction Centers, Inc.

Brentwood, Tennessee

We have audited the accompanying Historical Statements of Revenues and Certain Direct Operating Expenses of Greenhouse Real Estate, LLC and the related notes (“Historical Statements”), for the periods from August 10, 2011 (inception) to December 31, 2011, January 1, 2012 to December 31, 2012, and January 1, 2013 to October 7, 2013.

Management’s Responsibility for the Historical Statements

Management is responsible for the preparation and fair presentation of the Historical Statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation, and maintenance of internal control relevant to the preparation and fair presentation of the Historical Statements that are free from material misstatement, whether due to fraud or error.

Auditor’s Responsibility

Our responsibility is to express an opinion on these Historical Statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the Historical Statements are free from material misstatement.

An audit involves performing procedures to obtain evidence about the amounts and disclosures in the Historical Statements. The procedures selected depend on the auditor’s judgment, including the assessment of the risks of material misstatement of the Historical Statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity’s preparation and fair presentation of the Historical Statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity’s internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the Historical Statements.

We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.

Opinion

In our opinion, the Historical Statements referred to above present fairly, in all material respects, the revenues and certain direct operating expenses of Greenhouse Real Estate, LLC for the periods from August 10, 2011 (inception) to December 31, 2011, January 1, 2012 to December 31, 2012, and January 1, 2013 to October 7, 2013, in accordance with accounting principles generally accepted in the United States of America.

Emphasis of Matter

The accompanying Historical Statements were prepared for the purpose of complying with Rule 3-14 of the Securities and Exchange Commission Regulation S-X, as described in Note 2, and is not intended to be a complete presentation of Greenhouse Real Estate, LLC’s revenues and expenses. Our opinion is not modified with respect to this matter.

/s/ BDO USA, LLP

Memphis, Tennessee

April 24, 2014

 

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GREENHOUSE REAL ESTATE, LLC

HISTORICAL STATEMENTS OF REVENUES AND CERTAIN DIRECT OPERATING EXPENSES

FOR THE PERIODS FROM AUGUST 10, 2011 (INCEPTION) TO DECEMBER 31, 2011,

JANUARY 1, 2012 TO DECEMBER 31, 2012,

AND JANUARY 1, 2013 TO OCTOBER 7, 2013.

(DOLLARS IN THOUSANDS)

 

     Period from
August 10,
2011
(inception) to
December 31,
2011
     Period from
January 1,
2012 to
December 31,
2012
     Period
from
January 1,
2013 to
October 7,
2013
 

Rental income

   $ 382       $ 1,195       $ 1,265   

Certain direct operating expenses

                       
  

 

 

    

 

 

    

 

 

 

Revenues in excess of certain direct operating expenses

   $ 382       $ 1,195       $ 1,265   
  

 

 

    

 

 

    

 

 

 

See accompanying notes to historical statements of revenues and certain direct operating expenses.

 

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GREENHOUSE REAL ESTATE, LLC

NOTES TO HISTORICAL STATEMENTS OF REVENUES AND CERTAIN DIRECT OPERATING EXPENSES

1. Business

Greenhouse Real Estate, LLC (the Company) was formed on August 10, 2011 and owns real estate and improvements (the Property) known as The Greenhouse located in Grand Prairie, Texas. The Property is subject to a triple-net lease to Greenhouse Treatment Center, LLC, a subsidiary of American Addiction Centers, Inc., which commenced on August 1, 2011 for five years with initial payments of $90,000 per month and annual fixed rent escalators. The lease was amended in October 2012 to increase the monthly lease payment to $135,000. The lease expires in July 2016 and includes one 5-year optional renewal term. On October 1, 2013, the old lease was replaced with a new lease agreement with a term of fifteen years and monthly payments of $135,000 which escalate annually based on CPI. There were no direct operating expenses recorded in the books of the Company under the triple-net lease.

2. Basis of Presentation

The accompanying Combined Historical Statements of Revenues and Certain Direct Operating Expenses have been prepared for the purpose of complying with Rule 3-14 of the Securities and Exchange Commission Regulation S-X and are not intended to be a complete presentation of the Company’s revenues and expenses. The financial statements have been prepared on the accrual basis of accounting and require management of the Company to make estimates and assumptions that affect the reported amounts of the revenues and expenses during the reporting period. Actual results may differ from those estimates.

3. Rental Income

The lease agreement is accounted for as an operating lease. Rental income is recognized as earned over the life of the lease agreement on a straight-line basis.

Future minimum lease payments due from Greenhouse Treatment Center, LLC as of October 7, 2013 were as follows (in thousands):

 

Remainder of 2013

   $ 355   

2014

     1,620   

2015

     1,620   

2016

     1,620   

2017

     1,620   

2018

     1,620   

2019 and thereafter

     15,795   
  

 

 

 

Total

   $ 24,250   
  

 

 

 

4. Subsequent Events

The Company has evaluated subsequent events through April 24, 2014.

 

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LOGO

American Addiction Centers seeks to facilitate real hope and to instill the tools within an individual to learn, grow, heal and transform his or her life. Desert Hope Las Vegas, Nevada


Table of Contents

 

LOGO

Shares
American Addiction Centers
People Who Care. An Approach That Works.
American Addiction Centers has facilities located across the United States.
Desert Hope
Las Vegas, Nevada
Greenhouse
Dallas, Texas
Forterus
Southern California
Singer Island
Palm Beach, Florida
The Academy
Palm Beach, Florida
FitRx
Brentwood, Tennessee
AAC Holdings, Inc.
Common Stock
Prospectus
                    , 2014
William Blair
Wells Fargo Securities
Raymond James
Avondale Partners
Until                     , 2014, all dealers that effect transactions in shares of our common stock, whether or not participating in this offering, may be required to deliver a prospectus. This is in addition to the dealers’ obligation to deliver a prospectus when acting as underwriters and with respect to their unsold allotments or subscriptions.


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PART II

INFORMATION NOT REQUIRED IN PROSPECTUS

 

Item 13. Other Expenses of Issuance and Distribution

The following table sets forth all costs and expenses, other than underwriting discounts and commissions, paid or payable by us in connection with the sale of the common stock being registered. All amounts shown are estimates except for the SEC registration fee, the FINRA filing fee and the listing fee for the NYSE.

 

     Amount Paid or to
be Paid
 

SEC registration fee

   $ 9,660   

FINRA filing fee

     11,750   

NYSE listing fee

     *   

Blue sky qualification fees and expenses

     *   

Printing and engraving expenses

     *   

Legal fees and expenses

     *   

Accounting fees and expenses

     *   

Transfer agent and registrar fees and expenses

     *   

Miscellaneous expenses

     *   
  

 

 

 

Total

   $ *   

 

* To be provided by amendment

 

Item 14. Indemnification of Directors and Officers

Nevada law provides that a Nevada corporation may indemnify any person who was or is a party or is threatened to be made a party to any threatened, pending or completed action, suit or proceeding, whether civil, criminal, administrative or investigative, except an action by or in the right of the corporation (i.e., a “non-derivative proceeding”), by reason of the fact that he or she is or was a director, officer, employee or agent of the corporation, or is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise, against expenses, including attorneys’ fees, judgments, fines and amounts paid in settlement actually and reasonably incurred by him or her in connection with the action, suit or proceeding if he or she:

 

    is not liable under Section 78.138 of the Nevada Revised Statutes for breach of his or her fiduciary duties to the corporation; or

 

    acted in good faith and in a manner which he or she reasonably believed to be in or not opposed to the best interests of the corporation, and, with respect to any criminal action or proceeding, had no reasonable cause to believe his or her conduct was unlawful.

In addition, a Nevada corporation may indemnify any person who was or is a party or is threatened to be made a party to any threatened, pending or completed action or suit by or in the right of the corporation to procure a judgment in its favor (i.e., a “derivative proceeding”) by reason of the fact that he or she is or was a director, officer, employee or agent of the corporation, or is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise against expenses, including amounts paid in settlement and attorneys’ fees actually and reasonably incurred by him or her in connection with the defense or settlement of the action or suit if he or she:

 

    is not liable under Section 78.138 of the Nevada Revised Statute for breach of his or her fiduciary duties to the corporation; or

 

    acted in good faith and in a manner which he or she reasonably believed to be in or not opposed to the best interests of the corporation.

 

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Under Nevada law, indemnification may not be made for any claim, issue or matter as to which such a person has been adjudged by a court of competent jurisdiction, after exhaustion of all appeals therefrom, to be liable to the corporation or for amounts paid in settlement to the corporation, unless and only to the extent that the court in which the action or suit was brought or other court of competent jurisdiction determines upon application that in view of all the circumstances of the case, the person is fairly and reasonably entitled to indemnity for such expenses as the court deems proper.

To the extent that a director, officer, employee or agent of a corporation has been successful on the merits or otherwise in defense of any non-derivative proceeding or any derivative proceeding, or in defense of any claim, issue or matter therein, the corporation shall indemnify him or her against expenses, including attorneys’ fees, actually and reasonably incurred in connection with the defense.

Further, Nevada law permits a Nevada corporation to purchase and maintain insurance or to make other financial arrangements on behalf of any person who is or was a director, officer, employee or agent of the corporation, or is or was serving at the request of the corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise for any liability asserted against him or her and liability and expenses incurred by him or her in his or her capacity as a director, officer, employee or agent, or arising out of his or her status as such, whether or not the corporation has the authority to indemnify him or her against such liability and expenses.

Under our current articles of incorporation and our amended and restated bylaws, which we refer to as our bylaws, which bylaws will be effective upon the closing of this offering, we are obligated to indemnify any director, officer, employee or agent of the company to the fullest extent permitted by Nevada law as described above.

In addition, indemnification is required to continue as to a person who has ceased to be a director or officer and inures to the benefit of his or her heirs, executors and administrators. However, subject to the exceptions detailed below, we may indemnify a person seeking indemnification in connection with a proceeding (or part thereof) initiated by the person seeking indemnification only if the proceeding (or part thereof) was authorized by our Board of Directors. We may indemnify any employee or agent of us to an extent greater than required by law only if and to the extent that our directors, in their discretion, may determine.

If we do not pay a claim for indemnification (following the final disposition of the proceeding with respect to which indemnification is sought, including any settlement of such action, suit or proceeding) or advancement of expenses under our bylaws in full within 30 days after a written claim has been received by us, the claimant may bring suit against us to recover the unpaid amount of the claim and, if successful in whole or in part, the claimant also will be entitled to be paid the expense of prosecuting such claim to the fullest extent permitted by applicable law. We may defend against an action brought for this purpose that the claimant has not met the standards of conduct that make it permissible under Chapter 78 of the Nevada Revised Statutes for us to indemnify the claimant for the amount claimed, but the burden of proving such defense is on us. Neither our failure (including the failure of our Board of Directors, independent legal counsel or our stockholders) to have made a determination prior to the commencement of such action that indemnification of the claimant is proper in the circumstances because he or she has met the applicable standard of conduct set forth in Chapter 78 of the Nevada Revised Statutes, nor an actual determination by us (including our Board of Directors, independent legal counsel or our stockholders) that the claimant has not met such applicable standard of conduct is a defense to the action or creates a presumption that the claimant has not met the applicable standard of conduct.

Insofar as indemnification for liabilities arising under the Securities Act may be permitted to our directors, officers and controlling persons pursuant to the foregoing provisions, or otherwise, we have been advised that in the opinion of the SEC this indemnification is against public policy as expressed in the Securities Act and is therefore unenforceable.

 

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Item 15. Recent Sales of Unregistered Securities

Set forth below is information regarding securities sold by Holdings or AAC within the past three fiscal years that were not registered under the Securities Act. Also included is information relating to the section of the Securities Act, or rule of the SEC, under which exemption from registration was claimed.

Reorganization Transactions

In connection with the Reorganization Transactions, on April 15, 2014 Holdings issued to certain directors, executive officers, and certain other persons and their affiliates an aggregate of 9,975,885 shares of common stock. Also in connection with the Reorganization Transactions, Holdings assumed the 2007 Plan, which resulted in 71,156 shares of unvested restricted common stock of AAC previously issued to certain of our executive officers being automatically converted into 71,156 shares of unvested restricted common stock of Holdings.

Prior Exempt Transactions by AAC

In April 2014, AAC issued 3,019 shares of common stock to a non-executive employee under the 2007 Plan. Also in April 2014, AAC issued 49,496 of restricted shares of common stock to an executive employee under the 2007 Plan. AAC received no payments from the employees upon issuance of the shares, which had a fair value of $12.76 per share.

In March 2014, AAC issued an aggregate of 18,565 shares of common stock to its non-employee directors, each of whom is an accredited investor, in consideration for their service to the Board in 2013. AAC received no payments from the non-employee directors upon issuance of the shares, which had a fair value of $12.76 per share.

From February 2014 through April 2014, AAC issued 471,843 shares of common stock, at a price of $12.76 per share, to certain accredited investors, for an aggregate offering price of $6,020,717.

From March 2013 through April 2013, AAC issued 918,589 shares of common stock, at a price of $8.23 per share, to certain accredited investors, for total consideration of $7,559,987. As part of this offering, AAC issued an additional 243,013 shares of common stock to two accredited investors, at a price of $8.23 per share, in connection with the partial conversion of outstanding promissory notes in the aggregate principal amount of approximately $2,000,000.

During 2013, AAC issued 272,638 shares of common stock to certain executive officers. AAC received no payments from these executive officers upon issuance of the shares, which had fair values of $8.23 per share and $10.19 per share.

In August 2012, AAC issued 888,868 shares of common stock, which had a fair value of $6.27 per share, to one accredited investor in connection with the acquisition of certain assets of AJG Solutions, Inc. and the equity of B&B Holdings Intl LLC.

From March 2012 through April 2012, in connection with the purchase by certain accredited investors of $950,000 in total principal amount of 12% subordinated promissory notes, AAC issued to such purchasers warrants to purchase 7,548 shares of common stock per $100,000 principal amount of notes purchased. In March and April 2014, each warrant holder from this offering exercised such holder’s warrant(s), resulting in the issuance by AAC of a total of 71,705 shares of common stock.

On July 1, 2011, in connection with AAC’s merger with Performance Revolution, LLC, AAC issued 3,018,900 shares of common stock, which had a fair value of $0.01 per share, and 4,000 shares of Series B Preferred Stock, which had a fair value of $0.01 per share, to certain accredited investors who were the owners of the membership interests of Performance Revolution, LLC.

 

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On June 2, 2011, AAC issued 685,388 shares of common stock to two accredited investors as payment of accrued Series C Preferred Stock dividends in lieu of cash payments of $1,043,972.69. AAC also issued 5,909,280 shares of common stock to two accredited investors upon the conversion of all of the outstanding shares of Series C Preferred Stock.

None of the transactions set forth in this Item 15 involved any underwriters, underwriting discounts or commissions or any public offering. These transactions were made in reliance upon Section 4(a)(2) of the Securities Act (or Rule 506 of Regulation D promulgated thereunder) as transactions by an issuer not involving a public offering or Rule 701 promulgated under Section 3(b) of the Securities Act pursuant to a compensatory benefit plan approved by AAC’s board of directors. The recipient of the securities in each of these transactions represented his, her or its intentions to acquire the securities for investment only and not with a view to or for sale in connection with any distribution thereof, and appropriate legends were placed upon the stock certificates or book-entry positions representing the shares issued in each of these transactions. In each case, the recipient had adequate access, through his, her or its relationship with AAC, to information about AAC. All share amounts in the transactions described in this Item 15 reflect the effect of a 100-to-1 reverse split of all AAC capital stock that became effective August 27, 2012.

 

Item 16. Exhibits and Financial Statement Schedules

See Exhibit Index following the signature page to this Registration Statement.

 

Item 17. Undertakings

The undersigned registrant hereby undertakes to provide to the underwriters at the closing specified in the underwriting agreement certificates in such denominations and registered in such names as required by the underwriters to permit prompt delivery to each purchaser.

Insofar as indemnification for liabilities arising under the Securities Act may be permitted to directors, officers and controlling persons of the registrant pursuant to the foregoing provisions, or otherwise, the registrant has been advised that in the opinion of the Securities and Exchange Commission such indemnification is against public policy as expressed in the Securities Act and is, therefore, unenforceable. In the event that a claim for indemnification against such liabilities (other than the payment by the registrant of expenses incurred or paid by a director, officer or controlling person of the registrant in the successful defense of any action, suit or proceeding) is asserted by such director, officer or controlling person in connection with the securities being registered, the registrant will, unless in the opinion of its counsel the matter has been settled by controlling precedent, submit to a court of appropriate jurisdiction the question whether such indemnification by it is against public policy as expressed in the Securities Act and will be governed by the final adjudication of such issue.

The undersigned registrant hereby undertakes that:

(1) For purposes of determining any liability under the Securities Act, the information omitted from the form of prospectus filed as part of this registration statement in reliance upon Rule 430A and contained in a form of prospectus filed by the registrant pursuant to Rule 424(b)(1) or (4) or 497(h) under the Securities Act shall be deemed to be part of this registration statement as of the time it was declared effective.

(2) For the purpose of determining any liability under the Securities Act, each post-effective amendment that contains a form of prospectus shall be deemed to be a new registration statement relating to the securities offered therein, and the offering of such securities at that time shall be deemed to be the initial bona fide offering thereof.

 

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SIGNATURES

Pursuant to the requirements of the Securities Act of 1933, the registrant has duly caused this registration statement to be signed on its behalf by the undersigned, thereunto duly authorized, in the City of Brentwood, State of Tennessee, on the 15th day of August, 2014.

 

AAC HOLDINGS, INC.
By:  

/s/ Michael T. Cartwright

  Michael T. Cartwright
  Chief Executive Officer and Chairman

POWER OF ATTORNEY

KNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature appears below constitutes and appoints Michael T. Cartwright, Kirk R. Manz, and Kathryn Sevier Phillips and each of them, his or her true and lawful attorneys-in-fact and agents with full power of substitution, for him or her and in his or her name, place and stead, in any and all capacities, to sign any and all amendments (including post-effective amendments) to this registration statement, and to sign any registration statement for the same offering covered by the registration statement that is to be effective upon filing pursuant to Rule 462(b) promulgated under the Securities Act, and all post-effective amendments thereto, and to file the same, with all exhibits thereto and all documents in connection therewith, with the Securities and Exchange Commission, granting unto said attorneys-in-fact and agents, and each of them, full power and authority to do and perform each and every act and thing requisite and necessary to be done in and about the premises, as fully to all intents and purposes as he or she might or could do in person, hereby ratifying and confirming all that said attorneys-in-fact and agents or any of them, his, hers or their substitute or substitutes, may lawfully do or cause to be done or by virtue hereof.

Pursuant to the requirements of the Securities Act of 1933, this Registration Statement has been signed by the following persons in the capacities and on the dates indicated.

 

SIGNATURE

  

TITLE

 

DATE

/s/ Michael T. Cartwright

    
Michael T. Cartwright   

Chief Executive Officer and Chairman

(principal executive officer)

  August 15, 2014

/s/ Kirk R. Manz

    
Kirk R. Manz   

Chief Financial Officer

(principal financial officer)

  August 15, 2014

/s/ Andrew W. McWilliams

    
Andrew W. McWilliams   

Chief Accounting Officer

(principal accounting officer)

  August 15, 2014

*

    
Jerrod N. Menz    President and Director   August 15, 2014

*

    
Darrell S. Freeman, Sr.    Lead Independent Director   August 15, 2014

*

    
Jerry D. Bostelman    Director   August 15, 2014

*

    
Lucius E. Burch, III    Director   August 15, 2014

 

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SIGNATURE

  

TITLE

 

DATE

/s/ David C. Kloeppel

    
David C. Kloeppel    Director   August 15, 2014

/s/ Richard E. Ragsdale

    
Richard E. Ragsdale    Director   August 15, 2014

* By: /s/ Kathryn Sevier Phillips

    

Kathryn Sevier Phillips

Attorney-in-fact

     August 15, 2014

 

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EXHIBIT INDEX

 

Exhibit

No.

 

Description

  1.1*   Form of Underwriting Agreement
  2.1†**   Contribution Agreement by and among AAC Holdings, Inc., Michael T. Cartwright, Jerrod N. Menz and Kirk R. Manz, dated as of April 15, 2014
  2.2†**   Contribution Agreement by and among Tina F. Cartwright, Victoria Menz, AAC Holdings, Inc. and, solely for the purposes of Section 4.6, Clinical Revenue Managements Services, LLC, dated as of April 15, 2014
  2.3†**   Asset and Equity Purchase Agreement by and among American Addiction Centers, Inc., AJG Solutions, Inc., Member Assistance Solutions, LLC, James D. Bevell, Jr., and Michael Blackburn, dated as of August 31, 2012
  2.4†**   Purchase and Sale Agreement by and between American Addiction Centers, Inc. and the Sisters of Saint Francis of Philadelphia, dated as of April 17, 2013
  3.1**   Articles of Incorporation of AAC Holdings, Inc.
  3.2**   Form of Amended and Restated Bylaws of AAC Holdings, Inc.
  4.1   Form of Certificate of Common Stock of AAC Holdings, Inc.
  4.2**   Agreement Among Stockholders by and among Michael Cartwright, Jerrod Menz, James D. Bevell, Jr. and American Addiction Centers, Inc., dated as of August 31, 2012
  5.1   Form of Opinion of Ballard Spahr LLP
10.1+**   AAC Holdings, Inc. 2007 Stock Incentive Plan
10.2+**   Form of Restricted Share Award Agreement under the 2007 Stock Incentive Plan
10.3+**   AAC Holdings, Inc. 2014 Equity Incentive Plan
10.4+*   Form of Restricted Share Award under the AAC Holdings, Inc. 2014 Equity Incentive Plan
10.5+**   American Addiction Centers, Inc. 2014 Cash Incentive Plan
10.6+**   Form of Director Indemnification Agreement
10.7**   Amended and Restated Limited Liability Company Agreement of Behavioral Healthcare Realty, LLC, dated as of April 15, 2014
10.8**   Second Amended and Restated Credit Agreement by and among AAC Holdings, Inc., American Addiction Centers, Inc., the lenders party thereto from time to time (the “Lenders”), and Wells Fargo Bank, National Association, as administrative agent and collateral agent for the Lenders, dated as of April 15, 2014
10.9**   Letter Agreement re: Second Amended and Restated Credit Agreement dated April 15, 2014 by and among AAC Holdings, Inc., American Addiction Centers, Inc., the lenders party thereto from time to time and Wells Fargo Bank, National Association, as administrative agent and collateral agent for the Lenders, dated as of June 13, 2014
10.10**   First Amendment to Second Amended and Restated Credit Agreement by and among AAC Holdings, Inc., American Addiction Centers, Inc., the lenders party thereto and Wells Fargo Bank, National Association, as administrative agent and collateral agent for the Lenders, dated as of June 30, 2014
10.11**   Promissory Note by and between American Addiction Centers, Inc. and Wells Fargo Bank, National Association, dated as of July 31, 2013
10.12**   Term Note by and between American Addiction Centers, Inc. and Wells Fargo Bank, National Association, dated as of May 1, 2013
10.13**   Building Loan Agreement by and between Greenhouse Real Estate, LLC and Wells Fargo Bank, National Association, dated as of October 8, 2013

 

II-7


Table of Contents

Exhibit

No.

 

Description

10.14**   Promissory Note Secured by Deed of Trust by and between Greenhouse Real Estate, LLC and Wells Fargo Bank, National Association, dated as of October 8, 2013
10.15**   Repayment Guaranty by and among Behavioral Healthcare Realty, LLC, Michael Cartwright, Jerrod Menz and Wells Fargo Bank, National Association, dated as of October 8, 2013
10.16**   Consent and First Amendment to Loan Agreement by and among Greenhouse Real Estate, LLC, Michael T. Cartwright, Jerrod N. Menz, American Addiction Centers, Inc., Behavioral Healthcare Realty, LLC and Wells Fargo Bank, National Association, dated as of April 15, 2014
10.17**   Loan Agreement by and between Concorde Real Estate, LLC and Wells Fargo Bank, National Association, dated as of May 15, 2013
10.18**   Promissory Note Secured by Deed of Trust by and between Concorde Real Estate, LLC and Wells Fargo Bank, National Association, dated as of May 15, 2013
10.19**   Repayment Guaranty by and among Michael Cartwright, Jerrod Menz, American Addiction Centers, Inc. and Wells Fargo Bank, National Association, dated as of May 15, 2013
10.20**   Consent and First Amendment to Loan Agreement by and among Concorde Real Estate, LLC, Michael T. Cartwright, Jerrod N. Menz, American Addiction Centers, Inc., Behavioral Healthcare Realty, LLC and Wells Fargo Bank, National Association, dated as of April 15, 2014
10.21**   Loan Agreement by and between The Academy Real Estate, LLC and Wells Fargo Bank, National Association, dated as of May 10, 2013
10.22**   Promissory Note Secured by Mortgage by and between The Academy Real Estate, LLC and Wells Fargo Bank, National Association, dated as of May 10, 2013
10.23**   Repayment Guaranty by and among Michael Cartwright, Jerrod Menz, American Addiction Centers, Inc. and Wells Fargo Bank, National Association, dated as of May 10, 2013
10.24**   Modification Agreement by and between The Academy Real Estate, LLC and Wells Fargo Bank, National Association, dated as of November 7, 2013
10.25**   Consent and Amendment to Loan Agreement and Note by and among The Academy Real Estate, LLC, Michael T. Cartwright, Jerrod N. Menz, American Addiction Centers, Inc., Behavioral Healthcare Realty, LLC and Wells Fargo Bank, National Association, dated as of April 15, 2014
10.26**  

Amendment to Loan Agreement and Note by and among The Academy Real Estate, LLC,

Michael T. Cartwright, Jerrod N. Menz, American Addiction Centers, Inc., Behavioral Healthcare Realty, LLC and Wells Fargo Bank, National Association, dated as of April 15, 2014

10.27**   Term Loan Agreement by and between AAC Holdings, Inc., Guarantor and Reliant Bank, dated as of May 2, 2014
10.28**   Term Loan Promissory Note by and between AAC Holdings, Inc. and Reliant Bank, dated as of May 2, 2014
10.29**   Continuing Guaranty by American Addiction Centers, Inc., in favor of Reliant Bank, dated as of May 2, 2014
10.30**   Continuing Guaranty by Michael T. Cartwright in favor of Reliant Bank, dated as of May 2, 2014
10.31**   Continuing Guaranty by Jerrod N. Menz in favor of Reliant Bank, dated as of May 2, 2014
10.32**   Continuing Guaranty by Kirk R. Manz in favor of Reliant Bank, dated as of May 2, 2014
10.33**   Amended and Restated Subordinated Promissory Note in the principal amount of $2,355,331 made by American Addiction Centers, Inc. in favor of Michael Blackburn, dated as of April 2, 2013
10.34**   Subordinated Promissory Note in the principal amount of $3,170,000 made by American Addiction Centers, Inc. in favor of James D. Bevell, dated as of August 31, 2012
10.35**   Subordinated Promissory Note in the principal amount of $600,000 made by American Addiction Centers, Inc. in favor of Michael Blackburn, dated as of August 31, 2012

 

II-8


Table of Contents

Exhibit

No.

 

Description

10.36**   Form of 12% Secured Subordinated Note by and among American Addiction Centers, Inc. and certain accredited investors
10.37**   License Agreement by and between AJG Solutions, Inc. and American Addiction Centers, Inc., dated as of August 31, 2012
10.38   Form of Management Services Agreement by and between American Addiction Centers, Inc. and each professional physician group
10.39   Professional Services Agreement by and among San Diego Addiction Treatment Center, Inc. and San Diego Professional Group, P.C., dated as of August 5, 2014
10.40   Professional Services Agreement by and among Forterus Health Care Services, Inc. and San Diego Professional Group, P.C., dated as of August 5, 2014
10.41   Professional Services Agreement by and among Singer Island Recovery Center LLC and Palm Beach Professional Group, Professional Corporation, dated as of August 5, 2014
10.42   Professional Services Agreement by and among Singer Island Recovery Center LLC d/b/a The Academy and Palm Beach Professional Group, Professional Corporation, dated as of August 5, 2014
10.43   Professional Services Agreement by and among Concorde Treatment Center, LLC d/b/a Desert Hope Center and Las Vegas Professional Group – Calarco, P.C., dated as of August 5, 2014
10.44   Professional Services Agreement by and among FitRx, LLC and Brentwood Professional Group, P.C., dated as of August 5, 2014
10.45   Professional Services Agreement by and among Greenhouse Treatment Center, LLC d/b/a The Greenhouse and Grand Prairie Professional Group, P.A., dated as of August 5, 2014
10.46   Amended and Restated Loan Agreement by and among Greenhouse Real Estate, LLC and Wells Fargo Bank, National Association, dated as of August 13, 2014 (amends and restates Exhibit 10.13)
10.47   Real Estate Term Note made by Greenhouse Real Estate, LLC in favor of Wells Fargo Bank, National Association, dated as of August 13, 2014 (amends and restates Exhibit 10.14)
21.1   List of subsidiaries
23.1   Consent of BDO USA, LLP
23.2*   Consent of Ballard Spahr LLP (included in Exhibit 5.1)
24.1   Power of Attorney (included on signature page)

 

* To be filed by amendment.

** Previously filed.

† Schedules and exhibits have been omitted pursuant to Item 601(b)(2) of Regulation S-K. AAC Holdings, Inc. hereby undertakes to furnish supplementally copies of any of the omitted schedules and exhibits upon request by the Securities and Exchange Commission.

+ Denotes a management contract or compensatory plan or arrangement.

 

II-9

Exhibit 4.1

 

LOGO

INCORPORATED UNDER THE LAWS OF
SPECIMEN CERTIFICATE
Stock Certificate Number
Number of Shares
ACC HOLDINGS, INC.
COMMON STOCK
THIS CERTIFIES THAT
is the owner of Shares of the Capital Stock of
AAC HOLDINGS, INC.
transferable only on the books of the Corporation by the holder hereof in
person or by Attorney upon surrender of this Certificate property endorsed.
In Witness Whereof, the said Corporation has caused this Certificate to be signed
by its duty authorized officers and its Corporate Seal to be hereunto affixed
this day of A.D.
PRESIDENT SECRETARY
SHARES $0.001 par value EACH
ILLEGIBLE 196


LOGO

THE SECURITIES REPRESENTED HEREBY HAVE BEEN
ACQUIRED FOR INVESTMENT AND HAVE NOT BEEN
REGISTERED UNDER THE SECURITIES ACT OF 1933. SUCH
SHARES MAY NOT BE SOLD, PLEDGED, OR TRANSFERRED
IN THE ABSENCE OF SUCH REGISTRATION OR VALID
EXEMPTION FROM THE REGISTRATION AND
PROSPECTUS DELIVERY REQUIREMENTS OF SAID ACT.
CERTIFICATE FOR
SHARES
of the
Capital Stock
AAC HOLDINGS, INC.
ISSUED TO
DATE
For Value Received, hereby sell, assign, and transfer
unto
Shares
of the Capital Stock represented by the within
Certificate, and do hereby irrevocably constitute and appoint
Attorney
to transfer the said Stock on the books of the within named
Corporation with full power of substitution in the premises.
Dated ,20
In presence of
NOTICE. THE SIGNATURE OF THIS ASSIGNMENT
MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE
FACE OF THE CERTIFICATE, IN EVERY PARTICULAR, WITHOUT
ALTERATION OR ENLARGEMENT, OR ANY CHANGE WHATEVER.

Exhibit 5.1

 

LOGO

 

LOGO

                    , 2014

AAC Holdings, Inc.

115 East Park Drive, Second Floor

Brentwood, TN 37027

 

  Re: Registration Statement on Form S-1

Ladies and Gentlemen:

We have acted as Nevada counsel to AAC Holdings, Inc., a Nevada corporation (the “ Corporation ”), in connection with the Corporation’s Registration Statement on Form S-1 (the “ Registration Statement ”) filed with the United States Securities and Exchange Commission (the “ Commission ”) on the date referenced above under the Securities Act of 1933, as amended (the “ Securities Act ”), for the registration of [ ] shares (the “ Shares ”) of the Corporation’s common stock, $0.001 par value per share, including Shares issuable upon the exercise of the underwriters’ over-allotment option.

We have examined the following documents: (a) the Amended and Restated Articles of Incorporation of the Corporation, as filed with the Nevada Secretary of State on February 12, 2014; (b) the form of Amended and Restated Bylaws of the Corporation to become effective prior to the closing of the sale of the Shares contemplated by the Registration Statement (the “ Bylaws ”), filed as Exhibit 3.2 to the Registration Statement; and (c) the Registration Statement. We have also examined such corporate records and other agreements, documents and instruments, and such certificates or comparable documents of public officials and officers and representatives of the Corporation, and have made such inquiries of such officers and representatives and have considered such matters of law as we have deemed appropriate as the basis for the opinion hereinafter set forth.

We have assumed the legal capacity and competence of natural persons, the genuineness of all signatures, the authenticity of all documents submitted to us as originals, the conformity to original documents of documents submitted to us as certified, conformed, photostatic, electronic or facsimile copies, and the accuracy and completeness of all documents reviewed by us. In rendering the opinion set forth below, we have relied as to factual matters upon certificates, statements and representations of, and other information obtained from, the

Atlanta  |  Baltimore  |  Bethesda  |  Denver  |  Las Vegas  |  Los Angeles  |  New Jersey  |  New York  |  Philadelphia  |  Phoenix  |  Salt Lake City  |  San Diego  |  Washington, DC  |  Wilmington  |  www.ballardspahr.com


AAC Holdings, Inc.

                    , 2014

Corporation, its officers and representatives, public officials and other sources. We have assumed the conformity of the documents filed with the Commission via the EDGAR system, except for required EDGAR formatting changes, to physical copies of the documents submitted for our examination.

In making our examination of documents executed by parties other than the Corporation, we have assumed that such parties had the power, corporate or other, to enter into and perform all obligations thereunder and have also assumed the due authorization of all requisite action, corporate or other, and execution and delivery by such parties of such documents and the validity and binding effect thereof with respect to such parties.

On the basis of the foregoing, and subject to the qualifications, assumptions, and limitations set forth herein, we are of the opinion that, with respect to the offering of the Shares by the Corporation pursuant to the Registration Statement, when (i) the Registration Statement has become effective under the Securities Act, and (ii) the Shares have been duly and properly sold, paid for and delivered as contemplated in and strictly in adherence with the Registration Statement and the applicable definitive underwriting agreement approved by the board of directors of the Corporation or any duly designated committee thereof, then the Shares will be duly authorized, validly issued, fully paid and non-assessable.

This opinion is limited to the present laws of the State of Nevada. We express no opinion as to the laws of any other jurisdiction and no opinion regarding the statutes, administrative decisions, rules and regulations or requirements of any county, municipality or subdivision or other local authority of any jurisdiction.

We do not undertake to advise you or anyone else of any changes in the opinions expressed herein resulting from changes in law, changes in fact or any other matters that hereafter might occur or be brought to our attention.

We hereby consent to the sole use of this opinion as an exhibit to the Registration Statement and to the use of our name under the heading “Legal Matters” in the prospectus included therein. In giving this consent, we do not admit that we are within the category of persons whose consent is required by Section 7 of the Securities Act and the rules and regulations promulgated thereunder.

Very truly yours,

Exhibit 10.38

FORM OF MANAGEMENT SERVICES AGREEMENT

This Management Services Agreement (the “Agreement”) is made and entered into effective as of the              day of                     , 2014 (the “Effective Date”) by and between                      (“Practice”) and American Addiction Centers, Inc. (“Manager”).

RECITALS

WHEREAS , Practice provides addiction treatment and related medical services through physicians and mid-level providers (“Practitioners”) at one or more behavioral health facilities (the “Facilities”) in the State of California (the “State”) that are owned or operated by Manager or its affiliates; and

WHEREAS , Manager provides management, administrative and consulting services to medical practices and offers various systems that are designed to support the Practice in a manner that enables the provision of quality medical services; and

WHEREAS , Practice desires to engage Manager to provide management, administrative and consulting services to Practice so that it may concentrate its efforts and time more fully on the practice of medicine and on the delivery of quality medical and/or nursing services to patients at the Facilities; and

WHEREAS , Manager is willing to provide said services to Practice on the terms and conditions provided in this Agreement.

NOW, THEREFORE, the parties hereby agree as follows:

ARTICLE 1

ENGAGEMENT AND TERM

1.1 Engagement of Manager . Practice hereby engages Manager to provide management services with respect to Practice as described in this Agreement on the terms and conditions described herein, and Manager accepts such engagement, subject to the terms and conditions of this Agreement.

1.2 Term . The term of this Agreement, including the Initial Term and any Renewal Term (the “Term”) shall continue until terminated as provided in Article 6 of this Agreement.

ARTICLE 2

DUTIES AND RESPONSIBILITIES OF MANAGER

During the Term, subject to the provisions of Section 3.1 herein, Manager shall provide, in exchange for the Management Fee, all such services as are necessary and appropriate for the day-to-day administration and management of Practice in a manner consistent with good business practice, including without limitation those services set forth in this Article 2.


2.1 Accounting; Financial Services . Manager shall establish and administer accounting procedures and controls and systems for the development, preparation and keeping of records and books of accounting related to the business and financial affairs of Practice. Additionally, should Practice require working capital or additional capital to fund its cost of operations, including the payroll expenses for Practice’s Practitioners, Manager may provide such financing to the Practice, or arrange for such financing on behalf of Practice, on commercially reasonable terms, and Practice shall promise to pay, repay and/or guarantee the payment of any such financing. At no time shall the Manager be obligated to offset, forgive or repay any such financing. Any such financing shall be secured by the accounts receivable of the Practice or the proceeds thereof to the extent permitted by applicable federal or state law.

2.2 Reports and Information . Manager shall furnish Practice in a timely fashion annual or more frequent operating reports and other reports as reasonably requested by Practice, including without limitation financial statements and information.

2.3 Budgets . Manager shall prepare for review by Practice all capital and annual operating budgets for Practice as needed.

2.4 Supplies . Manager shall arrange for the purchase of medical and office supplies to the extent necessary for the operation of the Practice.

2.5 Licenses . Manager shall coordinate all reasonable and necessary actions to maintain all licenses, permits and certificates required for the operation of the Practice.

2.6 Policies and Practice Guidelines . Subject to Section 3.1, Manager shall develop, provide and revise policies and operating procedures pertaining to Practice’s operations (“Practice Guidelines”), subject to Practice’s review and approval.

2.7 Personnel . To the extent allowable under applicable law, Manager shall establish and implement guidelines for the recruitment, selection, hiring, firing, compensation, terms, conditions, obligations and privileges of employment or engagement of Practitioners. Manager will also further assist Practice in recruiting new Practitioners and other personnel and will carry out such administrative functions as may be appropriate for such recruitment, including identifying potential candidates, assisting Practice in examining and investigating the credentials of such potential candidates, and arranging interviews with such potential candidates; provided, however, if required by applicable law, Practice shall interview and make the ultimate decision as to whether to employ or retain a specific candidate. All Practitioners recruited with the assistance of Manager to render professional services on behalf of Practice at the Facilities shall be the employees or independent contractors of Practice, to the extent required by applicable law.

2.8 Training . Manager shall train Practice personnel with respect to all aspects of the Facilities’ operations (other than clinical, medical or patient care), including, without limitation, administrative, financial and equipment maintenance matters.

2.9 Insurance . Manager shall arrange for the purchase by Practice of necessary insurance coverage for Practice and, to the extent applicable, the Practitioners.

 

2


2.10 Maintenance of Equipment . Manager shall arrange for the provision of maintenance of the Practice’s equipment, if applicable, subject to Practice maintaining care, custody and control of any medical equipment used in the provision of medical services.

2.11 Expenditures . Manager shall manage all cash receipts and disbursements of Practice, including the payment on behalf of Practice of all taxes, assessments, licensing fees and other fees of any nature whatsoever as the same become due and payable, unless payment thereof is being contested in good faith by Practice.

2.12 Contract Negotiations . Manager shall advise Practice with respect to and negotiate, either directly or on Practice’s behalf, as appropriate and permitted by applicable law, such contractual arrangements with third parties as are reasonably necessary and appropriate for Practice’s provision of healthcare services at the Facilities, including, without limitation, price agreements with third party payors, alternative delivery systems, or other purchasers of group healthcare services; provided that no contract or arrangement regarding the provision of medical care at the Facilities or otherwise shall be entered into without Practice’s consent. Manager shall also provide community relations services if requested by Practice.

2.13 Billing and Collection . Subject to Section 2.14 below, on behalf of and for the account of Practice, Manager shall establish and maintain credit and billing and collection policies and procedures and shall exercise reasonable efforts to bill and collect, or arrange for a third party billing and collection services company to bill and collect, in a timely manner all professional and other fees for all billable services provided by Practice. In connection with the billing and collection services to be provided hereunder, Practice hereby appoints Manager (or its designee) as Practice’s exclusive true and lawful agent, and Manager hereby accepts such appointment, solely for the following purposes:

(a) To bill (or arrange for the billing), in Practice’s name and on Practice’s behalf, all claims for reimbursement or indemnification from patients, insurance companies and plans, all state or federally funded benefit plans and all other third party payors or fiscal intermediaries/carriers for all covered billable medical care provided by or on behalf of Practice; and

(b) To collect and receive (or arrange for the collection and receipt), in Practice’s name and on Practice’s behalf, all accounts receivable generated by the Practice’s billings and claims for reimbursement, to take possession of, endorse in the name of Practice, and deposit into Practice’s account any notes, checks, money orders, insurance payments, and any other instruments received in payment of accounts receivable for medical care provided by or on behalf of Practice, to administer such accounts including, but not limited to, extending the time or payment of any such accounts for cash, credit or otherwise; discharging or releasing the obligors of any such accounts; suing, assigning or selling at a discount such accounts to collection agencies; or taking other reasonable measures to require the payment of any such accounts.

Upon request of Manager, Practice shall execute and deliver to the financial institution at which Practice’s account is maintained such additional documents or instruments as Manager may reasonably request to demonstrate its authority.

 

3


2.14 Deposit of Governmental Payor Funds . To the extent applicable, Practice and/or Manager shall deposit in Practice’s account (i.e., a bank account Practice shall have exclusive dominion and control over that is opened by Practice at a bank mutually agreed upon by the parties, whose deposits are FDIC insured and that is not providing financing to Practice or Manager, or, if it is providing financing to Practice or Manager, such bank has stated in writing in the applicable loan agreement that it waives its right of offset) any and all governmental payor (i.e., Medicare, Medicaid, TRICARE, etc.) collections collected by Practice or by Manager on Practice’s behalf pursuant to Section 2.13 above (or any other payments required by law to pass first through the sole control of Practice) with respect to services provided at the Facilities. To the extent that Practice, any of its employees or agents receives funds for services paid for or reimbursed by governmental payors, such funds shall be deposited in Practice’s account.

2.15 Litigation Management . Manager shall (a) manage and direct (subject to any malpractice insurance policies or requirements) the general defense of all claims, actions, proceedings or investigations against Practice or any of its officers, directors, employees or agents in their capacity as such and arising out of or related to the operation of Practice, and (b) manage and direct the initiation and prosecution of all claims, actions, proceedings or investigations brought by Practice against any person other than Manager with respect to the operation of Practice.

ARTICLE 3

RELATIONSHIP OF THE PARTIES

3.1 Sole Authority to Practice . Notwithstanding the other provisions of this Agreement, Practice shall have exclusive authority and control over the healthcare aspects of Practice and its practice to the extent they constitute the practice of a licensed profession, including all diagnosis, treatment and ethical determinations with respect to patients which are required by law to be decided by a licensed professional. Any delegation of authority by Practice to Manager that would require or permit Manager to engage in the practice of a profession shall be prohibited and deemed ineffective, and Practice shall have the sole authority with respect to such matters. Manager shall not be required or permitted to engage in, and Practice shall not request Manager to engage in, activities that constitute the practice of medicine, nursing or another similar profession in the states in which Practice operates. Manager shall not direct, control, attempt to control, influence, restrict or interfere with Practice’s or any of the physicians’ or Practitioners’ exercise of independent clinical, medical or professional judgment in providing healthcare or medical related services.

3.2 Relationship of the Parties . Nothing contained herein shall be construed as creating a partnership, trustee, fiduciary joint venture or employment relationship between Manager and Practice. In performing all services required hereunder, Manager shall be in the relation of an independent contractor to Practice, providing services to the Facilities operated by Practice.

3.3 No Patient Referrals . Manager shall neither have nor exercise any control or direction over the number, type or recipient of patient referrals and nothing in this Agreement shall be construed as directing or influencing such referrals. Nothing in this Agreement is to be construed to restrict the professional judgment of Practice or any Practitioner to use any medical

 

4


practice or facility where necessary or desirable in order to provide proper and appropriate treatment or care to a patient or to comply with the wishes of the patient. No part of this Agreement shall be construed to induce, encourage, solicit or reimburse the referral of any patients or business, including any patient or business funded in whole or in part by federal or state government programs (i.e., Medicare, Medicaid, TRICARE, etc.). The parties acknowledge that there is no requirement under this Agreement or any other agreement between the parties that either refer patients to the other or any of their respective affiliates. No payment made under this Agreement shall be in return for the referral of patients or business, including those paid in whole or in part by federal or state government programs.

3.4 Compliance with Corporate Practice of Medicine . The parties hereto have made all reasonable efforts to ensure that this Agreement complies with the corporate practice of medicine prohibitions in the states in which it operates. The parties hereto understand and acknowledge that such laws may change, be amended, have guidance or have a different interpretation and the parties intend to comply with such laws in the event of such occurrences. Under this Agreement, Practice and its Practitioners shall have the exclusive authority and control over the medical aspects of Practice to the extent they constitute the practice of medicine, while Manager shall have the sole authority to manage the business aspects of Practice as more fully described in Article 2 of this Agreement. Manager shall not direct, control, attempt to control, influence, restrict or interfere with Practice’s or any of its Practitioners’ exercise of independent clinical, medical or professional judgment in providing healthcare or medical related services.

ARTICLE 4

RESPONSIBILITIES OF PRACTICE

Practice shall provide and perform the following during the Term:

4.1 Practitioners . Subject to Article 2 and to the right of Manager to establish and implement guidelines for the recruiting, selection, hiring, firing, compensation, terms, conditions, obligations and privileges of employment or engagement of Practitioners who work in the Facilities, Practice shall have the authority to engage (whether as employees or as independent contractors), promote, discipline, suspend and terminate the services of all licensed professional/clinical employees. Practice shall employ or contract with all Practitioners who provide professional or clinical services on behalf of Practice in the Facilities upon terms mutually satisfactory to Practice and Manager. Practice shall control all aspects of the practice of medicine, including clinical training and clinical supervision of the Practitioners. Notwithstanding the foregoing, Practice and Manager shall mutually agree on the amount of compensation payable to Practitioners who work in the Facilities. Practice shall ensure that all Practitioners employed or contracted by Practice to work in the Facilities are appropriately supervised with respect to the provision of services to patients in accordance with all applicable laws. Specifically, Practice and its supervising physician(s) shall have full responsibility for and shall supervise and control all Practitioners employed or engaged by Practice to provide medical or health-related services in the Facilities as required by applicable law. Practice shall consult with Manager from time to time regarding the number, work schedules and evaluation of the Practitioners employed or engaged by Practice to work in the Facilities. Practice shall staff the Facilities as required for the efficient operation of the Facilities, and as otherwise necessary to meet the requirements of payor contracts and applicable law. In addition, each Practitioner employed or engaged by Practice to work in the Facilities shall:

 

5


4.1.1 Maintain an unrestricted license to practice in the states in which it operates, maintain all required narcotics and controlled substances numbers and licenses, including without limitation a DEA registration or permit, and maintain good standing with the applicable professional boards;

4.1.2 Perform services and otherwise operate in accordance with all laws and with prevailing and applicable standards of care;

4.1.3 Maintain his or her skills through continuing education and training;

4.1.4 Maintain eligibility for professional liability insurance for his or her specialty;

4.1.5 In the case of nurse practitioners or physician assistants, practice under a licensed physician’s supervision, control and responsibility as required by applicable law. Each such collaboration plan or supervision arrangement must be reviewed and approved by Practice and Manager, before the Practitioner shall be permitted to practice on behalf of Practice in the Facilities. In addition, Practice and Manager must approve the collaborating or supervising physician based upon standards established by Practice and Manager from time to time;

4.1.6 Avoid all personal acts, habits and usages which might injure in any way, directly or indirectly, his or her professional judgment or professional reputation; and

4.1.7 Not be (and shall avoid being) suspended or excluded from any federal or state healthcare program (e.g., Medicare, Medicaid or TRICARE).

4.1.8 Subject to Section 3.1, adhere to the Practice Guidelines, except to the extent that verbal authority is given to deviate from the Practice Guidelines in each particular instance by a supervising physician or other physician employee of Practice.

4.2 Security Interest . To secure Practice’s obligations to Manager hereunder, Practice herby grants Manager a security interest, to the extent permitted by applicable law in each case, in all property, if any, which Practice may now own or may hereafter acquire (the “Collateral”) including, without limitation the following:

4.2.1 All inventory of Practice, whether now owned or hereafter acquired;

4.2.2 All equipment, machinery, tools, fixtures, furnishings, leasehold improvements, furniture, vehicles or goods of Practice, whether now owned or hereafter acquired;

4.2.3 All accounts receivable, accounts, contracts, contract rights, chattel paper, and chooses in action, now or hereafter due or owing to, or owned by, Practice;

 

6


4.2.4 All general intangibles now or hereafter owned by Practice, including, without limitations, books and records, notes, instruments, licenses, and trade names;

4.2.5 All insurance policies and proceeds thereof; and

4.2.6 All proceeds and products of the foregoing.

Practice shall execute such financing statements and other documents as shall be necessary to perfect (and maintain the perfection of) said security interest as requested by Manager. Upon a default hereunder or other breach that results in the termination of this Agreement, or non-payment by Practice hereunder that is not cured by Practice within thirty (30) days after receipt of written notice of default, Manager shall be entitled to exercise all rights and remedies under state law including, without limitation, all rights and remedies of a secured party under the Uniform Commercial Code for the applicable state in which Practice operates. Practice shall not sell, assign, transfer or encumber any of the Collateral without Manager’s prior written consent. Practice acknowledges and understands that Manager may assign the foregoing security interest in the Collateral to any Person or entity that may from time to time provide financing to Manager, and Practice consents to such assignment.

ARTICLE 5

FINANCIAL ARRANGEMENTS

5.1 Application of Payments . The parties agree that Manager shall apply Practice’s monthly revenues (including any revenues received from the Facilities in return for professional services rendered at the Facilities) for the following purposes, in the order set out below:

5.1.1 Patient/Payor Refunds . The Practice revenues shall first be applied to pay any refunds or rebates owed to patients or payors.

5.1.2 Costs and Expenses of Clinical Personnel . Practice revenues shall next be applied to pay all costs and expenses, including the salary, bonus and benefit expenses and other compensation, of all Practitioners and any other employees or contractors of Practice providing services at the Facilities.

5.1.3 Practice Leases . Practice revenues shall next be applied to Practice lease payments, if any.

5.1.4 Other Purchases and Expenses . Practice revenues shall next be applied to reimburse Manager for all of its direct costs and expenses (including malpractice insurance expenses) incurred under this Agreement for the benefit of Practice and applied to any other Practice purchases and/or expenses incurred by the Practice.

5.1.5 Management Fee . Practice revenues shall next be applied to pay Manager a monthly management fee (the “Management Fee”) in an amount equal to twenty percent (20%) of the Practice’s collected revenues.

5.1.6 Repayment . Practice revenues shall next be applied to repay outstanding debt owed by Practice to Manager.

 

7


5.1.7 Balance . The balance of Practice’s revenues shall be retained by Practice.

The Management Fee shall be paid monthly in arrears based on the Practice’s net pre-tax income, subject to an annual reconciliation process. Manager shall send in writing, electronically or otherwise monthly invoices to Practice. The parties agree that the Management Fee is fair and equitable, commercially reasonable and consistent with fair market value in exchange for the management services provided hereunder.

5.2 Budget . Manager shall prepare an annual budget for Practice showing expected revenues and expenses of Practice, and shall revise such budgets as the parties deem appropriate from time to time.

ARTICLE 6

TERM AND TERMINATION

6.1 Term . The initial term of this Agreement shall be for ten (10) years from the Effective Date (the “Initial Term”). This Agreement shall automatically renew for additional five (5) year terms after the Initial Term, on the same terms, conditions and provisions as contained herein, together with any authorized and approved amendments hereto (each a “Renewal Term”), unless otherwise earlier terminated as provided herein.

6.2 Termination By Manager Without Cause . At any time Manager may terminate this Agreement without cause upon ninety (90) days advance written notice to Practice.

6.3 Immediate Termination By Manager . Manager shall have the right, but not the obligation, to terminate this Agreement immediately upon notice to Practice of any of the following events:

6.3.1 The revocation, suspension, cancellation or restriction, in any manner, of the license to practice medicine in any state in which it operates.

6.3.2 The conviction of Practice, any shareholder of Practice or any Practitioner employed or engaged by Practice to work in the Facilities of any crime punishable as a felony under federal or state law or of any health care crime.

6.3.3 The cancellation or non-renewal of the professional or malpractice insurance of Practice, any shareholder of Practice or any Practitioner employed or engaged by Practice to work in the Facilities.

6.3.4 The dissolution of Practice.

6.3.5 The suspension or exclusion of Practice, any shareholder of Practice or any Practitioner employed or engaged by Practice to work in the Facilities from any state or federal healthcare program (e.g., Medicare, Medicaid, or TRICARE).

6.3.6 Failure of Practice to pay the Management Fee in the time frames set forth in Article 5 hereof and after written notice from Manager and an additional reasonable opportunity to cure.

 

8


6.4 Immediate Termination By Practice . Practice shall have the right, but not the obligation, to terminate this Agreement immediately upon notice to Manager of any of the following events:

6.4.1 The conviction of Manager of any crime punishable as a felony under federal or state law or of any health care crime.

6.4.2 The suspension or exclusion of Manager from any state or federal healthcare program (e.g., Medicare, Medicaid, or TRICARE).

6.5 Termination By Either Party . This Agreement may be terminated as follows:

 

  (a) By mutual written agreement of the parties.

 

  (b) By either party immediately upon the filing of a petition in bankruptcy or the insolvency of the other party.

 

  (c) By either party upon a material breach of a material provision hereof by the other party, provided that the non-breaching party provides the breaching party with ninety (90) days written notice of any such breach, during which period of time the breaching party shall have the opportunity to cure any such breach (or in the event of a non-monetary breach which is not curable within such 90 day period the breaching party shall have the opportunity to commence cure of any such breach). If any such breach is cured by the breaching party during such period of time (or in the event of a non-monetary breach which is not curable within such 90 day period but the breaching party has commenced to cure such breach and does continue to cure such breach with the exercise of due diligence), it shall be as if such breach never occurred and this Agreement shall continue in full force and effect, unaffected by the non-breaching party’s notice.

 

  (d) By either party pursuant to Section 10.15 (“Limited Renegotiation”) hereof.

6.6 Effect of Termination . In the event of termination, Practice shall no longer have any right to any of the services provided by Manager hereunder and shall no longer have the right to use or otherwise benefit from the Marks (as defined in Section 8.1) or Intellectual Property (as defined in Section 8.2), in any form or fashion or any similar name, trademark or logo. Practice shall return to Manager any equipment, records and other items provided hereunder and cease using the Marks or Intellectual Property, and any trademarks, service mark or other name similar thereto. Practice shall also immediately take all steps necessary to change its trade names to cease using the Marks.

 

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ARTICLE 7

RECORDS AND RECORD KEEPING

7.1 Access to Information . Practice hereby authorizes and grants to Manager reasonable access to information, instruments and documents relating to Practice that may be reasonably requested by Manager to perform its obligations hereunder and shall disclose and make available to representatives of Manager for review and photocopying all such books, agreements, papers, records and information.

7.2 Patient Records .

7.2.1 The management services herein shall include Manager’s retention and maintenance of patient medical records on behalf of Practice, to the extent permitted by, and in full accordance with all applicable laws and regulations regarding confidentiality and retention and ownership of records.

7.2.2 At all times during and after the Term of this Agreement, all business records and information, including, without limitation, all books of account and general administrative records and all information generated under or contained in the management information system pertaining to Practice shall be and remain the sole property of Practice.

7.2.3 Practice shall at all times during the Term, and at all times thereafter, make available to Manager for inspection by its authorized representatives, during regular business hours, any of Practice’s records necessary for Manager to perform its services and carry out its responsibilities hereunder or necessary for the defense of any legal or administrative action or claim relating to said records.

7.3 Confidentiality of Records . Manager and Practice will adopt procedures to assure the confidentiality of the records relating to the operations of Manager and Practice and the Facilities, including, without limitation, all statistical, financial and personnel data related to the operations of Manager and Practice and the Facilities, which information is not otherwise available to third parties publicly or by law.

7.4 Maintenance, Retention and Storage of Records . Manager agrees to maintain, retain and store on behalf of Practice, in such form and manner as required by applicable law, all records relating to Practice and in its possession, including, but not limited to, patient medical records, at its sole cost and expense, for the longer of (i) ten (10) years, (ii) in cases of patients under minority, their complete records shall be retained for the period of not less than one (1) year after the minor reaches the age of majority, or ten (10) years from the date of Practice’s last professional contact with the patient, whichever is longer, (iii) in the case of mentally incompetent patients, their medical records shall be maintained indefinitely, (iv) in the case of immunization records, those records shall be retained indefinitely, (v) in the case of mammography records, those records shall be retained for a period of at least twenty (20) years, or (vi) the period required by applicable law. Thereafter, Manager shall be entitled to dispose of such patient medical records as it deems necessary or appropriate; provided, however, Manager shall provide prior written notice to Practice of its intent to dispose of such records and shall

 

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provide Practice with a sixty (60) calendar day period, from the date that such notice is given by Manager, for Practice to take control of or copy any or all of the records to be disposed of by Manager, at the sole cost and expense of Practice, to the extent permitted by applicable law.

7.5 HIPAA . Manager, as a business associate of Practice, agrees to comply to the extent applicable with all applicable federal, state and local laws, including without limitation the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and all implementing regulations issued pursuant thereto, as may be amended from time to time (45 CFR Parts 160-164). Manager shall protect the confidentiality, privacy and security of all medical records or other health-related information that Manager or any employee or agent of Manager creates or receives for or from Practice pursuant to this Agreement. Manager agrees to comply with the HIPAA Business Associate Addendum attached hereto as Addendum A and incorporated by reference.

 

ARTICLE 8

INTELLECTUAL PROPERTY AND OTHER PROPRIETARY INFORMATION

8.1 Limited License . Manager hereby grants to Practice the nonexclusive right and license to use any names, trademarks, service marks, design marks or logos provided by Manager to Practice in connection with this Agreement or otherwise utilized by Practice in connection with this Agreement (collectively, the “Marks”) during the Term of this Agreement and subject to the prior written approval of Manager. Manager is and shall be the sole owner and holder of all right, title and interest to the Marks. Immediately upon the expiration or termination of this Agreement for any reason, Practice shall cease all uses of the Marks and any similar name, trademark or logo. Practice acknowledges Manager’s ownership of the Marks and agrees that it will do nothing inconsistent with the ownership, validity, goodwill or value of the Marks. All use of the Marks by Practice and all goodwill associated therewith shall inure to the benefit of and be on behalf of Manager. Practice will not register or seek to register any trademark or service mark which includes the Marks, alone or in composite form with other words or designs, nor will Practice register or seek to register any trademark or service mark which would be similar to the Marks. Without limiting the generality of the foregoing, Practice shall not assert or claim that the Marks are descriptive, generic or otherwise attack the validity, title or any rights of Manager in or to the Marks or any Intellectual Property (as hereinafter defined). Practice will not sublicense the Marks or Practice’s rights under this Agreement without the prior written consent of Manager.

8.2 Proprietary Property . Manager is and shall be the exclusive owner and holder of all right, title and interest to the proprietary property of Manager, including without limitation, all copyrights, Marks, trade secrets, Confidential Business Information (as defined below), management information systems, forms, form contracts and policy manuals (collectively the “Intellectual Property”). Practice agrees that it shall not at any time knowingly harm, misuse or bring into disrepute the proprietary property of Manager. Practice shall promptly notify Manager in writing in the event it becomes aware of any third party infringing, misusing or otherwise violating any of the Marks or the Intellectual Property, or who that party believes is, or may be infringing, diluting or otherwise derogating the Marks or the Intellectual Property. Manager represents and warrants that all Intellectual Property is free from infringement or other adverse claims and agrees to defend, indemnify, and hold Practice harmless from and against any losses, damages or expenses (including attorneys’ fees) arising from any third party claim.

 

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8.3 Use of Management Information System (MIS) . Practice shall use all software and hardware provided by Manager pursuant to this Agreement only for the purpose of conducting Practice’s practice in the Facilities and solely in accordance with and subject to all of the terms and conditions of any license or sublicense agreements, leases or any other agreements that such software and hardware are subject to, and shall not allow or permit any person to use the software or hardware or any portion thereof in violation of this Agreement or any such license, sublicense, agreements, lease or any other agreements.

8.4 Manager Confidential Business Information . Practice acknowledges that during the course of its relationship with Manager hereunder, Practice may be given access to or may become acquainted with Manager’s Confidential Business Information (as defined below). In recognition of the foregoing and in addition to any other requirements of confidentiality under applicable law, Practice hereby agrees not to disclose or use any of the Manager’s Confidential Business Information (except in connection with the services rendered to Practice hereunder) during the Term of this Agreement and an additional period of five (5) years thereafter. For purposes of this Agreement, “Manager’s Confidential Business Information” shall mean any and all information, know-how and data, technical or non-technical, whether written, oral, electronic, graphic or otherwise of Manager that is reasonably considered or treated as confidential and proprietary, and shall include, but not be limited to:

 

  (a) business methods;

 

  (b) facilities and locations;

 

  (c) billing policies, procedures, processes and records;

 

  (d) tax returns and records;

 

  (e) any records, memoranda and correspondences dealing with the business of Manager;

 

  (f) financial, pricing and operational information, including all insurance records;

 

  (g) internal memoranda, emails or correspondence;

 

  (h) form agreements, checklists or pleadings;

 

  (i) contracts or agreements executed by or on behalf of Manager with any person or entity, including, but not limited to, hospitals, clinics and medical practices or offices;

 

  (j) information regarding advantageous business relationships with hospitals, other facilities, clinics and medical practices or offices;

 

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  (k) suppliers, marketing, and other information and know-how, all relating to or useful in Manager’s business and which have not been disclosed to the general public;

 

  (l) this Agreement and any agreements contemplated hereby;

 

  (m) operational and business systems, policies and procedures;

 

  (n) software and processes;

 

  (o) systems design;

 

  (p) algorithms;

 

  (q) business strategies;

 

  (r) business opportunities;

 

  (s) customer lists and information;

 

  (t) research and technical information;

 

  (u) outcomes and related data; and

 

  (v) intellectual property, know-how and trade secrets.

Practice agrees and acknowledges that the Manager’s Confidential Business Information, as such may exist from time to time, constitutes valuable, confidential, special and unique assets of Manager. The parties hereto agree that the documents relating to the business of Manager, including all of Manager’s Confidential Business Information, are the exclusive property of Manager. Practice understands and agrees that its obligations and duties under this Section do not cease upon termination of this Agreement and, further, Practice shall return all such documents (including any copies thereof) to Manager immediately upon the termination of this Agreement.

ARTICLE 9

NONCOMPETITION AND NONSOLICITATION PROVISIONS

9.1 During the Term of this Agreement and for a period of two (2) years after the termination or expiration of this Agreement for any reason, Practice and each of its physician shareholders (each individually referred to as “Shareholder”) shall not, without Manager’s prior written consent, directly or indirectly, anywhere within the Restricted Territory (as defined below): (i) establish, own or operate a medically assisted addiction therapy clinic or facility staffed by physicians, physician assistants or nurse practitioners and providing the services of physicians, physician assistants and nurse practitioners to the general public in a manner similar to the medically assisted addiction therapy clinic operated by the Facilities pursuant to this Agreement or (ii) in direct competition with Manager engage in or participate in the management of medically assisted addiction therapy clinics or facilities staffed by physicians, physician

 

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assistants or nurse practitioners and providing the services of physicians, physician assistants and nurse practitioners to the general public in a manner similar to the Facilities pursuant to this Agreement. For purposes of this Section, “Restricted Territory” shall mean any location within 25 miles of a Facility or other addiction therapy or behavioral health facility owned, operated, or managed by Manager or one of Manager’s affiliates.

9.2 During the Term of this Agreement and for a period of two (2) years after the termination or expiration of this Agreement for any reason, Practice and each Shareholder shall not, directly or indirectly without Manager’s prior written consent:

9.2.1 Solicit, hire or engage any individual working for, or previously working for, Manager, the Facilities, or Practice as an employee, independent contractor, consultant, agent or representative;

9.2.2 Induce or attempt to influence any employee or contractor of Manager, the Facilities, Practice to terminate his, her, or its employment or engagement with Manager, the Facilities or Practice; or

9.2.3 Restrict, limit, interfere, induce or influence any physician, nurse practitioner, physician assistant, nurse, laboratory technician, medical assistant or provider of health professional services that has provided services at the Facilities from becoming an employee or independent contractor of Manager (if permitted by applicable law) or of another practice or professional corporation that is managed by Manager. Practice further agrees to release any such physician, nurse practitioner, physician assistant, nurse, laboratory technician, medical assistant or provider from any non-compete or other similar restrictive covenant so that such individuals can be employed or engaged by Manager (if permitted by applicable law) or by another practice or professional corporation managed by Manager.

9.3 Practice shall ensure that any and all agreements between Practice and any Practitioner contain non-competition agreements and restrictive covenants satisfactory to Manager. Practice and each Shareholder shall take any and all steps necessary to enforce such restrictive covenants with such Practitioners to the fullest extent permitted by law.

9.4 Practice and each Shareholder understands and acknowledges that the foregoing provisions in this Section are designed to preserve the goodwill of Manager and its affiliates, the trade secrets of Manager, and the workforce of Manager and its owned, operated, or managed clinics.

9.5 Practice and each Shareholder understands and acknowledges that violation of this Section 9 will cause irreparable harm to Manager, the exact amount of which will be impossible to ascertain, and for that reason Practice and each Shareholder agrees that Manager shall be entitled to seek, without the necessity of showing any actual damage or posting a bond (unless required by law), from any court of competent jurisdiction temporary or permanent injunctive relief and/ or specific performance of this Agreement restraining Practice from any act prohibited by this Section 9.

 

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9.6 Nothing in this paragraph shall limit Manager’s right to recover any other damages or remedies to which it is entitled as a result of Practice’s or any Shareholder’s breach. If any one or more of the provisions of this Section 9 or any word, phrase, clause, sentence or other portion of this Section 9 (including without limitation the geographical, duration or scope of activity restrictions contained in this Section 9) shall be held to be unenforceable or invalid for any reason, such provision or portion of provision shall be modified or deleted in such a manner so as to make this Section 9, as modified, legal and enforceable to the fullest extent permitted under applicable law.

9.7 The provisions of this Section 9 shall survive the termination of this Agreement.

ARTICLE 10

GENERAL

10.1 Indemnification . Each of Practice and Manager hereby agrees to indemnify, defend and hold harmless the other, its officers, directors, owners, members, employees, agents, affiliates and subcontractors, from and against any and all claims, damages, demands, diminution in value, losses, liabilities, actions, lawsuits and other proceedings, judgments, fines, assessments, penalties, awards, costs and expenses (including reasonable attorneys’ fees), whether or not covered by insurance, arising directly out of (a) any material breach of any provision, warranty or representation contained in this Agreement or (b) any acts or omissions by such indemnifying party, its owners, employees, agents or subcontractors. The provisions of this Section 10.1 shall survive termination or expiration of this Agreement. A party seeking indemnification shall immediately notify the other of any lawsuits or actions, or any threat thereof, that are known or become known to it that might adversely affect any interest of Practice or Manager whatsoever.

10.2 Arbitration . All disputes relative to interpretation of the provisions of this Agreement or any other dispute arising among the parties shall be resolved by binding arbitration pursuant to the rules of the American Arbitration Association then pertaining. Arbitration proceedings shall be held in Nashville, Tennessee. The parties may, if they are able to do so, agree upon one arbitrator; otherwise, there shall be three (3) arbitrators selected to resolve disputes pursuant to this Section 10.2, one named in writing by each party within fifteen (15) days after notice of arbitration is served upon a party by the other party, and a third arbitrator selected by the two (2) arbitrators selected by the parties within fifteen (15) days thereafter. If one party does not choose an arbitrator within such fifteen (15) days, the other party shall request that the American Arbitration Association name such other arbitrator. No one shall serve as arbitrator who is in any way financially interested in this Agreement or in the affairs of either party or its affiliates. Each party shall pay its own expenses of arbitration and one-half of the expenses of the arbitrators. If any position by any party hereunder, or any defense or objection thereto, is deemed by the arbitrators to have been unreasonable, the arbitrators shall assess, as part of their award against the unreasonable party or reduce the award to the unreasonable party, all or part of the arbitration expenses (including reasonable attorneys’ fees) of the other party and of the arbitrators.

 

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10.3 Entire Agreement; Amendment . This Agreement constitutes the entire agreement between the parties related to the subject matter hereof and supersedes all prior agreements, understandings, and letters of intent relating to the subject matter hereof. This Agreement may be amended, modified or supplemented only by a writing executed by both parties.

10.4 Relationship of the Parties . The relationship of the parties is and shall be that of independent contractors, and nothing in this Agreement is intended as, and nothing shall be construed to create, an employer/employee relationship, partnership or joint venture relationship between the parties, or to allow either to exercise control or direction over the manner or method by which the other performs the services that are the subject matter of this Agreement; provided, however, that the services to be provided hereunder shall always be furnished in a manner consistent with the standards governing such services and the provisions of this Agreement.

10.5 Notices . Any notice or other communication required or desired to be given to either party shall be in writing and shall be deemed given when hand-delivered or deposited in the United States mail, first-class postage prepaid, addressed to the parties at the addresses set forth below. Any party may change the address to which notices and other communications are to be given by giving the other parties notice of such change.

 

If to Practice:

        

If to Manager:

  

American Addiction Centers, Inc.

115 East Park Drive, Second Floor

Brentwood, Tennessee 37027

Attn:    Michael T. Cartwright, Chairman and
Chief Executive Officer

Email:  fitrx@live.com

  

With a copy to:

  

American Addiction Centers, Inc.

115 East Park Drive, Second Floor

Brentwood, Tennessee 37027

Attn.:   Kathryn Sevier Phillips, General Counsel and
Secretary

Fax:   (615) 691-7130

Email:    ksphillips@contactaac.com

  

10.6 Counterparts . This Agreement may be executed in any number of counterparts, each of which shall be an original, but all of which, when taken together, will constitute one and the same instrument.

10.7 Governing Law . This Agreement shall be construed and governed in accordance with the laws of the State of Tennessee, without reference to conflict of law principles.

10.8 Assignment . This Agreement shall not be assignable by either party hereto without the express written consent of the other party.

 

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10.9 Waiver . Waiver of any agreement or obligation set forth in this Agreement by either party shall not prevent that party from later insisting upon full performance of such agreement or obligation and no course of dealing, partial exercise or any delay or failure on the part of any party hereto in exercising any right, power, privilege, or remedy under this Agreement or any related agreement or instrument shall impair or restrict any such right, power, privilege or remedy or be construed as a waiver therefor. No waiver shall be valid against any party unless made in writing and signed by the party against whom enforcement of such waiver is sought.

10.10 Binding Effect . Subject to the provisions set forth in this Agreement, this Agreement shall be binding upon and inure to the benefit of the parties hereto and upon their respective successors and assigns.

10.11 Severability . If any one or more of the provisions of this Agreement is adjudged to any extent invalid, unenforceable, or contrary to law by a court of competent jurisdiction, each and all of the remaining provisions of this Agreement will not be affected thereby and shall be valid and enforceable to the fullest extent permitted by law.

10.12 Force Majeure . Either party shall be excused for failures and delays in performance of its respective obligations under this Agreement due to any cause beyond the control and without the fault of such party, including without limitation, any act of God, war, terrorism, bio-terrorism, riot or insurrection, law or regulation, strike, flood, earthquake, water shortage, fire, explosion or inability due to any of the aforementioned causes to obtain necessary labor, materials or facilities. This provision shall not, however, release such party from using its best efforts to avoid or remove such cause and such party shall continue performance hereunder with the utmost dispatch whenever such causes are removed. Upon claiming any such excuse or delay for non-performance, such party shall give prompt written notice thereof to the other party, provided that failure to give such notice shall not in any way limit the operation of this provision.

10.13 Authorization for Agreement . The execution and performance of this Agreement by Practice and Manager have been duly authorized by all necessary laws, resolutions, and corporate or partnership action, and this Agreement constitutes the valid and enforceable obligations of Practice and Manager in accordance with its terms.

10.14 Duty to Cooperate . The parties acknowledge that the parties’ mutual cooperation is critical to the ability of Manager to perform successfully and efficiently its duties hereunder. Accordingly, each party agrees to cooperate fully with the other in formulating and implementing goals and objectives which are in the best interest of Practice’s patients.

10.15 Limited Renegotiation . This Agreement shall be construed to be in accordance with any and all federal and state laws, including laws relating to Medicare, Medicaid, and other third party payors. In the event there is a change in such laws, whether by statute, regulation, agency or judicial decision, guidance or interpretation that has any material effect on any Term of this Agreement, then the applicable term(s) of this Agreement shall be subject to renegotiation and either party may request renegotiation of the affected term or terms of this Agreement, upon written notice to the other party, to remedy such condition.

 

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The parties expressly recognize that upon request for renegotiation, each party has a duty and obligation to the other only to renegotiate the affected term(s) in good faith and, further, each party expressly agrees that its consent to proposals submitted by the other party during renegotiation efforts shall not be unreasonably withheld.

Should the parties be unable to renegotiate the term or terms so affected so as to bring it/them into compliance with the statute, regulation or judicial opinion, guidance or interpretation that rendered it/them unlawful or unenforceable within ninety (90) days of the date on which notice of a desired renegotiation is given, then either party shall be entitled, after the expiration of said ninety (90) day period, to terminate this Agreement upon thirty (30) additional days written notice to the other party.

[Remainder of Page Left Intentionally Blank]

 

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IN WITNESS WHEREOF, the parties have executed this Management Services Agreement as of the day and year first above written.

 

For Practice:     For Manager:
    American Addiction Centers, Inc.
By:         By:    
Name:     Name:  Michael T. Cartwright
Title:     Title:  Chairman and Chief Executive Officer

 

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ADDENDUM A

HIPAA BUSINESS ASSOCIATE ADDENDUM

This Business Associate Addendum (“Addendum”) amends and is made part of that certain Management Services Agreement between                              (“Entity”) and American Addiction Centers, Inc. (“Associate”).

Entity and Associate agree that the parties incorporate this Addendum into the Agreement in order to comply with the requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the Health Information Technology for Economic and Clinical Health Act (“HITECH”) and their implementing regulations set forth at 45 C.F.R. Parts 160 and Part 164 (the “HIPAA Rules”). To the extent Associate is acting as a Business Associate of Entity pursuant to the Agreement, the provisions of this Addendum shall apply, and Associate shall be subject to the penalty provisions of HIPAA as specified in 45 CFR Part 160.

1. Definitions. Capitalized terms not otherwise defined in this Addendum shall have the meaning set forth in the HIPAA Rules. References to “PHI” mean Protected Health Information maintained, created, received or transmitted by Associate from Entity or on Entity’s behalf.

2. Uses or Disclosures. Associate will neither use nor disclose PHI except as permitted or required by this Addendum or as Required By Law. To the extent Associate is to carry out an obligation of a Covered Entity under 45 CFR Part 164, Subparts A and E, Associate shall comply with the requirements of 45 CFR Part 164, Subparts A and E that apply to such Covered Entity in the performance of such obligation. Associate is permitted to use and disclose PHI:

(a) to perform any and all obligations of Associate as described in the Agreement, provided that such use or disclosure would not violate the HIPAA Rules, if done by Entity directly;

(b) as otherwise permitted by law, provided that such use or disclosure would not violate the HIPAA Rules, if done by Entity directly and provided that Entity gives its prior written consent;

(c) to perform Data Aggregation services relating to Entity’s health care operations;

(d) to report violations of the law to federal or state authorities consistent with 45 CFR § 164.502(j)(1);

(e) as necessary for Associate’s proper management and administration and to carry out Associate’s legal responsibilities (collectively “Associate’s Operations”), provided that Associate may only disclose PHI for Associate’s Operations if the disclosure is Required By Law or Associate obtains reasonable assurance, evidenced by a written contract, from the recipient that the recipient will: (1) hold such PHI in confidence and use or further disclose it only for the purpose for which it was disclosed or as Required By Law; and (2) notify Associate of any instance of which the recipient becomes aware in which the confidentiality of such PHI was breached;

 

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(f) to create de-identified information in accordance with 45 CFR § 164.514(b), provided that such de-identified information may be used and disclosed only consistent with applicable law;

(g) to create a limited data set as defined at 45 CFR §164.514(e)(2), provided that Associate will only use and disclose such limited data set for purposes of research, public health or health care operations and will comply with the data use agreement requirements of 45 CFR §164.514(e)(4), including that Associate will not identify the information or contact the individuals.

In the event Entity notifies Associate of a restriction request that would restrict a use or disclosure otherwise permitted by this Addendum, Associate shall comply with the terms of the restriction request.

3. Safeguards. Associate will use appropriate administrative, technical and physical safeguards to prevent the use or disclosure of PHI other than as permitted by this Addendum. Associate will also comply with the applicable provisions of 45 CFR Part 164, Subpart C with respect to electronic PHI to prevent any use or disclosure of such information other than as provided by this Addendum.

4. Subcontractors. In accordance with 45 CFR §§ 164.308(b)(2) and 164.502(e)(1)(ii), Associate will ensure that all of its subcontractors that create, receive, maintain or transmit PHI on behalf of Associate agree by written contract to comply with the same restrictions and conditions that apply to Associate with respect to such PHI, including but not limited to the obligation to comply with applicable provisions of 45 CFR Part 164, Subpart C.

5. Minimum Necessary. Associate represents that the PHI requested, used or disclosed by Associate shall be the minimum amount necessary to carry out the purposes of the Agreement. Associate will limit its uses and disclosures of, and requests for, PHI (i) when practical, to the information making up a Limited Data Set; and (ii) in all other cases subject to the requirements of 45 CFR § 164.502(b), to the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request.

6. Entity Obligations. Entity shall notify Associate of (i) any limitations in its notice of privacy practices, (ii) any changes in, or revocation of, permission by an individual to use or disclose PHI, and (iii) any confidential communication request or restriction on the use or disclosure of PHI that Entity has agreed to or with which Entity is required to comply, to the extent any of the foregoing affect Associate’s use or disclosure of PHI. Entity shall not request Associate to use or disclose PHI in a manner not permitted by the HIPAA Rules and shall obtain any permissions or authorizations, if any, required to disclose PHI to Associate pursuant to the Agreement.

7. Access and Amendment. In accordance with 45 CFR § 164.524, Associate shall permit Entity or, at Entity’s request, an individual (or the individual’s designee) to inspect and obtain copies of any PHI about the individual that is in Associate’s custody or control and that is

 

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maintained in a Designated Record Set. If the requested PHI is maintained electronically, Associate must provide a copy of the PHI in the electronic form and format requested by the individual, if it is readily producible, or, if not, in a readable electronic form and format as agreed to by Entity and the individual. Associate will, upon receipt of notice from Entity, promptly amend or permit Entity access to amend PHI so that Entity may meet its amendment obligations under 45 CFR § 164.526.

8. Accounting. Except for disclosures excluded from the accounting obligation by the HIPAA Rules and regulations issued pursuant to HITECH, Associate will record for each disclosure that Associate makes of PHI the information necessary for Entity to make an accounting of disclosures pursuant to the HIPAA Rules. In the event the U.S. Department of Health and Human Services (“HHS”) finalizes regulations requiring Covered Entities to provide access reports, Associate shall also record such information with respect to electronic PHI held by Associate as would be required under the regulations for Covered Entities beginning on the effective date of such regulations. Associate will make information required to be recorded pursuant to this Section available to Entity promptly upon Entity’s request for the period requested, but for no longer than required by the HIPAA Rules (except Associate need not have any information for disclosures occurring before the effective date of this Addendum).

9. Inspection of Books and Records. Associate will make its internal practices, books, and records, relating to its use and disclosure of PHI, available upon request to HHS to determine compliance with the HIPAA Rules.

10. Reporting. To the extent Associate becomes aware or discovers any use or disclosure of PHI not permitted by this Addendum, any Security Incident involving electronic PHI or any Breach of Unsecured Protected Health Information, Associate shall promptly report such use, disclosure, Security Incident or Breach to Entity. Associate shall mitigate, to the extent practicable, any harmful effect known to it of a Security Incident, Breach or use or disclosure of PHI by Associate not permitted by this Addendum. Notwithstanding the foregoing, the parties acknowledge and agree that this section constitutes notice by Associate to Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents (as defined below) for which no additional notice to Entity shall be required. “Unsuccessful Security Incidents” shall include, but not be limited to, pings and other broadcast attacks on Associate’s firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or disclosure of electronic PHI. All reports of Breaches shall be made in compliance with 45 CFR § 164.410.

11. Term. This Addendum shall be effective as of the effective date of the Agreement and shall remain in effect until termination of the Agreement. Either party may terminate this Addendum and the Agreement effective immediately if it determines that the other party has breached a material provision of this Addendum and failed to cure such breach within thirty (30) days of being notified by the other party of the breach. If the non-breaching party determines that cure is not possible, such party may terminate this Addendum and the Agreement effective immediately upon written notice to other party.

 

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Upon termination of this Addendum for any reason, Associate will, if feasible, return to Entity or destroy all PHI maintained by Associate in any form or medium, including all copies of such PHI. Further, Associate shall recover any PHI in the possession of its agents and subcontractors and return to Entity or securely destroy all such PHI. In the event that Associate determines that returning or destroying any PHI is infeasible, Associate may maintain such PHI but shall continue to abide by the terms and conditions of this Addendum with respect to such PHI and shall limit its further use or disclosure of such PHI to those purposes that make return or destruction of the PHI infeasible. Upon termination of this Addendum for any reason, all of Associate’s obligations under this Addendum shall survive termination and remain in effect (a) until Associate has completed the return or destruction of PHI as required by this Section and (b) to the extent Associate retains any PHI pursuant to this Section.

12. General Provisions. In the event that any final regulation or amendment to final regulations is promulgated by HHS or other government regulatory authority with respect to PHI, the parties shall negotiate in good faith to amend this Addendum to remain in compliance with such regulations. Any ambiguity in this Addendum shall be resolved to permit Entity and Associate to comply with the HIPAA Rules. Nothing in this Addendum shall be construed to create any rights or remedies in any third parties or any agency relationship between the parties. A reference in this Addendum to a section in the HIPAA Rules means the section as in effect or as amended. The terms and conditions of this Addendum override and control any conflicting term or condition of the Agreement and replace and supersede any prior business associate agreements in place between the parties. All non-conflicting terms and conditions of the Agreement remain in full force and effect.

 

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Schedule

Note : For the Exhibit listed in the first column below, only the Form of Management Services Agreement has been filed as an exhibit to the Registrant’s Form S-1 registration statement. This Schedule provides detail as to the actual Agreements entered into between AAC and the Professional Groups indicated below and lists the material details in which each such Agreement differs from the form of document filed.

 

 Exhibit 
No.
  

Practice Group

   Address    Date of Agreement
10.38    San Diego Professional Group, P.C.   

731 South Highway 101, Suite 1-E

Solano Beach, California 92075

Attn: Mark A. Calarco, D.O.

   August 1, 2014
       
     Palm Beach Professional Group, Professional Corporation   

4400 E. Congress Avenue

West Palm Beach, Florida 33407

Attn: Mark A. Calarco, D.O.

   August 1, 2014
       
     Las Vegas Professional Group – Calarco, P.C.   

2465 E. Twain Avenue, Suite 100

Las Vegas, Nevada 89121

Attn: Mark A. Calarco, D.O.

   August 1, 2014
       
     Brentwood Professional Group, P.C.   

204 Ward Circle, Suite 300B

Brentwood, Tennessee 37027

Attn: Mark A. Calarco, D.O.

   August 1, 2014
       
     Grand Prairie Professional Group, P.A.   

1171 107th Street, Suite A

Grand Prairie, Texas 75050

Attn: Mark A. Calarco, D.O.

   August 1, 2014

Exhibit 10.39

PROFESSIONAL SERVICES AGREEMENT

For Medical Staffing

THIS PROFESSIONAL SERVICES AGREEMENT for Medical Staffing (“ Agreement ”) is made this 5 th day of August, 2014 (the “ Effective Date ”), between San Diego Professional Group, P.C. (“ Practice ), a professional corporation organized under the laws of California, and San Diego Addiction Treatment Center, Inc., a Delaware corporation (“ Company ”) (individually, a “ Party ,” and, collectively, the “ Parties ”).

W I TN E S S E T H:

WHEREAS , Company has established and operates an addiction treatment facility, San Diego Addiction Treatment Center, Inc. (“ Facility ”), located at 2456 East Street, San Diego, California 92102;

WHEREAS , Practice employs Medical Providers and other medical personnel specializing in the treatment of various addictions;

WHEREAS , Practice is owned by a physician licensed to practice medicine in the state of California (the “ State ”); and

WHEREAS , Company desires to engage Practice as of the Effective Date to provide, or arrange the provision of, medical services on behalf of Company, and Practice desires to accept such engagement as of the Effective Date, all upon the terms and conditions set forth in this Agreement.

NOW , THEREFORE , for and in consideration of the mutual agreements, covenants, terms and conditions herein contained, the Parties agree as follows:

ARTICLE I

ESTABLISHMENT OF PROFESSIONAL RELATIONSHIP

1.1 Engagement of Practice . As of the Effective Date, Company engages Practice, and Practice accepts said engagement, to provide medical services in accordance with the terms and conditions of this Agreement.

1.2 Relationship of the Parties . In the performance of their respective duties and obligations hereunder, the Parties are independent contractors, and as such they shall remain professionally and economically independent of each other. The Parties are not, and shall not be deemed to be, joint venturers, partners, employees, or agents of each other (except with respect to an agency for billing and collection activities expressly addressed in this Agreement). Neither Party shall have any authority to bind or incur any financial obligations on behalf of the other without the other’s express written consent, and then only insofar as such authority is conferred by such express written consent.


ARTICLE II

PRACTICE’S OBLIGATIONS

2.1 General Obligations . Practice shall provide the Medical Provider services set forth on Schedule 2.1 , attached hereto and incorporated herein by reference.

2.2 Responsibility for Medical Provider Services . Practice shall control and be responsible for the provision of medical services to Patients (as such term is defined on Schedule 2.1 ), and Company shall not engage in the practice of medicine nor shall it intervene or interfere in professional medical judgment of Practice or any Medical Provider; provided , however, that Practice shall cause the Medical Providers to comply with Company’s systems and procedures for review and improvement of the delivery of care.

2.3 Qualifications and Standards . Practice shall take all necessary actions to ensure that each Medical Provider satisfies the following conditions at all times during the Term:

2.3.1 Licensure and Experience Levels . Each Medical Provider shall maintain an unrestricted license to practice his or her specialty in the State and at all times shall be in good standing with the appropriate licensing board. Each Medical Provider shall have a level of competence, experience and skill at least comparable to that prevailing in the community.

2.3.2 Federal DEA Number . The Medical Providers shall maintain a Federal DEA number without restrictions, to the extent necessary for his or her practice.

2.3.3 Medical Standards . Each Medical Provider shall perform all medical services to be provided hereunder in accordance with the current standards of care in the medical community and any credentialing and quality criteria that are adopted from time to time by Company, the Facility and/or Practice

2.3.4 Continuing Education . Medical Providers shall participate in such continuing medical education and training programs as required by law to maintain skills compatible with standards of medical care in the community.

2.3.5 Bylaws . Medical Providers shall comply with any bylaws, policies, rules or regulations of Facility or Company, as may be amended from time to time.

2.3.6 Laws . Medical Providers shall comply with all applicable standards, rulings, regulations and requirements of the United States Department of Health and Human Services, the State’s department of health, the applicable accreditation agency of the Facility, and any federal, state or local government agency, third party payor or accrediting body having jurisdiction over or providing reimbursement for the Facility and any programs and services offered by either the Facility or Company.

2.3.7 Cooperation . Practice shall promptly notify Company if a claim of malpractice or professional discipline is asserted against any Medical Provider resulting from medical services provided at Facility; additionally Practice shall notify Company of claims not yet asserted against Medical Providers, but the potential for which Practice is aware.

 

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2.3.8 Approval and Removal . Each Medical Provider shall be subject to the initial approval of Company before he or she commences providing services at Facility. In addition, Practice, at the request of Company, shall immediately remove a Medical Provider from Facility for cause. For purposes of this Section 2.3.8 , “for cause” shall be determined by Company acting reasonably and in good faith and shall include the following: (a) suspension or revocation or other sanction of his or her medical license, specialty board certification, or Federal Drug Enforcement Agency (“ DEA ”) registration; (b) suspension, revocation, or reduction of his or her status or privileges as a member of the medical staff of any hospital utilized by Company for Patients served by the Medical Providers (including without limitation any resignation of membership or privileges in lieu of or to avoid any of the foregoing actions); (c) being arrested or indicted for, or convicted of any felony or any criminal charge relating to the practice of medicine; (d) being found by the appropriate licensure board or other state or federal regulatory agency to have violated any provision of law or the applicable code of medical ethics; (e) cancellation, termination or non-renewal of his or her professional liability insurance and failure to obtain replacement coverage within thirty (30) days; or (f) having committed any actions or inactions which pose an immediate and significant threat to Patients.

2.4 Compensation Responsibility . Practice shall be solely responsible for establishing and paying the compensation and fringe benefits, if any, to the Medical Providers. Practice shall be solely responsible for the payment and withholding of appropriate amounts for income tax, social security, unemployment insurance, and state disability insurance taxes. Practice shall also maintain in full force and effect all worker’s compensation insurance as may be required under the worker’s compensation laws of the State.

2.5 Medical Provider Staffing Levels . As of the Effective Date, Practice shall assign to Facility Medical Providers necessary to satisfy the patient needs at the Facility.

2.6 Authority . Practice has the right to enter into this Agreement, and neither the execution of this Agreement nor Practice’s performance hereunder will result in it being in breach or default of any existing agreement.

ARTICLE III

COMPENSATION

3.1 General Compensation Principles . Practice shall be compensated for the services provided hereunder pursuant to the terms of this Agreement as described in Schedule 3.1 , which is attached hereto and incorporated herein by reference. The Parties hereby acknowledge and agree that such amount represents the fair market value of the services provided hereunder.

ARTICLE IV

PATIENT CHARGES, BILLING AND COLLECTION

4.1 Billing; Assignment of Fees . Company, directly or through an affiliate, shall bill payors and patients for all technical and facility fees of the Facility. In addition, to the extent permissible by applicable law and third party payor policies, Company may (directly or through

 

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an affiliate) bill payors and patients globally for Company’s services and also the professional services of Practice and the Medical Providers that are provided pursuant to this Agreement. Practice authorizes Company, directly or through an affiliate, to bill and collect all professional fees of Practice and the Medical Providers, as Practice’s and the Medical Providers’ agent and attorney-in-fact to the extent permitted by applicable law for all services rendered by Practice or the Medical Providers at the Facility or on behalf of Company hereunder, either in Company’s own name or in Practice’s or individual Medical Provider’s name and provider number. Practice shall ensure that each Medical Provider executes such documentation as may be necessary to permit such billing by Company. To the extent that it is not allowable by law or payor policies for Company to bill for services on behalf of Practice or Medical Providers, Practice will bill in its own name for such services, provided that Practice intends to engage American Addiction Centers, Inc., an affiliate of Company, to provide billing support services. Practice shall ensure that duplicative billing does not occur, and neither it nor any Medical Provider will payors or patients for the same services that are billed by Company.

4.2 Practice to Provide Billing Information . For all applicable services described in Section 4.1 above and in accordance with applicable law, Practice shall provide Company with all billing information for services rendered by the Medical Providers, including, but not limited to, the name of the Patient, the date of service, the nature and extent of services provided, Patient diagnosis, and any supporting medical and non-medical information necessary to bill such services and to obtain payment and/or reimbursement. Each Medical Provider shall provide the above-described billing information to Company within seven (7) calendar days after the applicable medical services are rendered. The applicable treating Medical Provider shall be responsible for appropriately coding the service provided and supplying the correct CPT, KEY, ICD-9 (or ICD-10 once applicable) or other codes associated with the service.

ARTICLE V

INSURANCE

5.1 Comprehensive General Liability and Property Insurance . Company shall procure and maintain during the Term of this Agreement comprehensive general liability insurance covering its activities relating to Facility and property insurance covering the Facility. The comprehensive general liability insurance maintained hereunder shall be in amounts deemed sufficient by Company to protect against risks and losses associated with the operations of Facility.

5.2 Company’s Professional Liability Insurance . Company shall procure and maintain in full force and effect during the Term of this Agreement professional liability insurance covering Company and appropriate personnel provided by Company pursuant to this Agreement, including, without limitation, Company’s provider employees and contractors (subject to prior approval of insurer), against errors and omissions arising from Patient services and/or non-medical services rendered by Company pursuant to this Agreement. All premiums, costs and expenses associated with such professional liability insurance shall be borne by and paid by Company. The professional liability insurance procured by Company shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate. For purposes of Sections 5.1 and 5.2 , the term “insurance” shall include self-insurance arrangements maintained by Company for itself and its corporate affiliates, including Facility.

 

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5.3 Practice’s Professional Liability Insurance . Practice shall procure and maintain in full force and effect during the Term of this Agreement, and for a period of three (3) years subsequent to the expiration or earlier termination of this Agreement, professional liability insurance (i.e., medical malpractice insurance) with an insurer acceptable to Company, protecting Practice and its shareholders, officers, directors, and the Medical Providers against errors and omissions arising from professional services and/or medical services rendered by Practice and the Medical Providers. Such policy of insurance shall name Company as an additional insured. The insurance required by this Section 5.3 shall specifically extend to acts or omissions of Medical Providers occurring both prior and subsequent to the Effective Date. All premiums, costs and expenses associated with such professional liability insurance shall be borne by Practice. The professional liability insurance required by this Section 5.3 shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate.

5.4 Proof of Insurance . At the request of the other Party, each Party shall furnish copies of or Certificates of Insurance on all policies required under this Article V (or evidence of self-insurance) as evidence of the insurance coverage to be procured pursuant to this Agreement. In the case of Company, this evidence shall also specifically include evidence of “tail” or other coverage for acts and omissions occurring prior to the Effective Date. The insurance coverage required under this Agreement shall not be canceled, modified, reduced or otherwise materially changed, except upon thirty (30) days’ prior written notice to the non-procuring Party.

ARTICLE VI

INDEMNIFICATION

6.1 Indemnification by Company . Company shall indemnify, defend and hold Practice, and the shareholders, directors, officers and employees of Practice, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs, and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly from any negligent or willful act or omission of Company or its non-Medical Provider employees providing services at Facility. Notwithstanding any provisions of the preceding sentence to the contrary, Company shall not be liable to Practice for any consequential, exemplary or punitive damages. The duty of Company to indemnify, defend and hold harmless Practice shall only apply to the extent that any such loss sustained by Practice is not covered by insurance. The indemnification provisions of this Section 6.1 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other.

6.2 Indemnification by Practice . Practice shall indemnify, defend and hold Company, and the shareholders, directors, officers and employees of Company, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly, from any negligent or willful act or omission of any Medical Provider, including, specifically, (i) negligent or willful acts occurring both prior to and subsequent to the Effective Date and (ii)

 

5


claims against Company attributable directly or indirectly to incorrect billing information provided to Company by Practice or any Medical Provider. Notwithstanding any provisions of the preceding sentence to the contrary, Practice shall not be liable to Company for any consequential, exemplary or punitive damages. The indemnification provisions of this Section 6.2 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other. A provision similar to that set forth in this Section 6.2 shall be contained in each contract between Practice and any independent contractor providing professional medical services for Practice at the Facility in order to ensure that each such Medical Provider has agreed to indemnify Company as required by this Section 6.2 .

ARTICLE VII

RECORDS AND CONFIDENTIALITY

7.1 Ownership of Records and Files . All business or medical records and files of whatever nature or kind, including Patients’ files and x-rays, are the property of Company to the extent permitted by law; neither Practice nor individual Medical Providers shall acquire any proprietary rights with respect to such records. However, at Practice’s written request, Company shall provide Medical Providers with copies of any records reflecting services performed by such Medical Provider with respect to (a) any claims against him/her in the nature of malpractice, (b) any charges against him/her issued by a licensing board or professional association or (c) for any other purpose deemed appropriate by Company

7.2 Confidentiality of Medical Records . Both Parties shall comply with all applicable federal and state laws and regulations regarding the confidential and secure treatment of individually identifiable health information, including 42 C.F.R. Part 2, and with the terms of the Business Associate Addendum attached as Schedule 7.2 hereto and incorporated herein by reference.

7.3 Medical Records upon Termination . Upon the expiration or earlier termination of this Agreement, unless a Patient specifies otherwise and in accordance with applicable law, Company shall be entitled to the original medical records for all Patients, and Practice shall be entitled to copy such records, with the cost of any copies to be home by Practice. For such period as is required by applicable statutes, Company shall keep possession of the original medical records and shall retain the records in their original condition, shall store the records in a safe place and make the records available to Practice without charge if reasonably necessary for any purpose, including, without limitation, Patient care and medical malpractice defense.

ARTICLE VIII

TERM AND TERMINATION

8.1 Term . This Agreement shall be effective for a term of five (5) years, beginning on the Effective Date, unless terminated pursuant to the provisions of this Article VIII (the “ Initial Term ”). Upon expiration of the Initial Term, this Agreement will automatically renew for additional one (1) year terms (the “ Renewal Terms ”) unless either Party shall provide notice to the other Party of its intent to terminate the Agreement under the terms of this Section 8.1 (“ Notice of Intent to Terminate ”). Notice of Intent to Terminate must be provided no later than one (1) year prior to the expiration of the Initial Term, and no later than ninety (90) days prior to the expiration of any Renewal Term.

 

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8.2 Termination upon Insolvency . If either Party shall apply for or consent to the appointment of a receiver, trustee or liquidation of itself, or if all or a substantial part of its assets, file a voluntary petition in bankruptcy or admit in writing its inability to pay its debts as they become due, make a general assignment for the benefit of creditors, file a petition or an answer seeking reorganization or arrangement with creditors, or take advantage of any insolvency law, or if an order, judgment, or decree shall be entered by a court of competent jurisdiction or an application of a creditor, adjudicating such party to be bankrupt or insolvent, or approving a petition seeking reorganization of such Party or appointing a receiver, trustee or liquidator of such Party or of all or a substantial part of its assets, and such order, judgment, or decree shall continue in effect and unstayed for a period of thirty (30) consecutive days, then the other Party may terminate this Agreement upon ten (10) days prior written notice to such Party.

8.3 Termination upon Legal Prohibitions of Relationship . If counsel jointly selected by the Parties should determine (the “ Determination ”) that it is more likely than not that applicable legislation, regulations, rules or procedures (collectively referred to herein as a “ Law ”) in effect or to become effective as of a date certain, or if Practice or Company receives notice (the “ Notice ”) of an actual or threatened decision, finding or action by any governmental or private agency or court (collectively referred to herein as an “ Action ”), which Law or Action, if or when implemented, would have the effect of subjecting either Party to civil or criminal prosecution under state and/or federal Laws, or other adverse proceeding on the basis of their participation herein, then the Parties shall attempt in good faith to amend this Agreement to the extent necessary in order to comply with such Law or to avoid the Action, as applicable. If, within ninety (90) days of providing written notice of such Determination or Notice to the other Party, the Parties acting in good faith are unable to mutually agree upon and make amendments or alterations to this Agreement to meet the requirements in question, or alternatively, the Parties mutually determine in good faith that compliance with such requirements is impossible or unfeasible, then this Agreement shall be terminated without penalty, charge or continuing liability upon the earlier of the following: the date one hundred eighty (180) days subsequent to the date upon which either Party gives written notice to the other Party or the effective date on which the Law or Action prohibits the relationship of the Parties pursuant to this Agreement.

8.4 Termination upon Breach . Either Party may elect to terminate this Agreement in the event that the other Party is in material breach of this Agreement and such default continues for a period of fifteen (15) calendar days after written notice thereof has been given to the Party in default by the other Party; provided , however, that Company may immediately terminate this Agreement if Practice fails to provide, or arrange the provision of, adequate professional medical services pursuant to this Agreement for a period of three (3) calendar days.

8.5 Termination Without Cause . This Agreement shall automatically terminate upon one hundred and eighty (180) days’ notice by either Party to the other Party.

8.6 Termination and Liabilities . In the event either Party validly elects to terminate this Agreement pursuant to the provisions of this Article VIII or the Agreement expires by its own terms, the liabilities and obligations of the Parties shall cease as of the date of termination,

 

7


except that each Party shall be responsible for: (a) any payments or other obligations arising or accruing prior to the termination date and (b) any breach arising after termination or expiration with respect to obligations that continue after such expiration or termination. Neither Party shall be liable to the other for any damages resulting from any event of force majeure. The Parties agree that upon such termination, they will mutually work to assure an orderly transition of services.

ARTICLE IX

GENERAL PROVISIONS

9.1 Independence of Medical Judgment . Nothing in this Agreement shall affect the exercise of Medical Providers’ independent medical judgment.

9.2 Entire Agreement; Amendment . This Agreement constitutes the entire agreement between the Parties pertaining to the subject matter contained herein and supersedes all prior and contemporaneous agreements, representations and understandings of the Parties which relate to the subject matter of this Agreement. No supplement, amendment or modification of this Agreement shall be binding unless executed in writing by the Parties, unless otherwise provided herein.

9.3 No Waiver . No waiver of any of the provisions of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the Party making the waiver.

9.4 Subject Headings . The subject headings of the Articles and Sections of this Agreement are included for purposes of convenience only, and shall not affect the construction or interpretation of any of the provisions of this Agreement.

9.5 Binding Agreement; No Assignment . This Agreement shall be binding upon, and shall inure to the benefit of, the Parties and their respective legal representatives, successors and assigns. Company may assign this Agreement upon prior written notice to Practice. Practice may not assign this Agreement nor any rights hereunder, nor may it delegate any of the duties to be performed hereunder without the prior written consent of Company; provided , however, that notwithstanding the foregoing sentence to the contrary, Practice shall have the right to assign this Agreement to another corporate affiliate of Company upon written notice and shall have the right to subcontract with any other responsible parties, including specifically, corporate affiliates of Practice, for the performance of various aspects of its obligations hereunder, provided that Practice shall remain fully responsible for the performance of any such subcontractors.

9.6 Severability . Except as otherwise provided in Section 8.3 , in the event any provision of this Agreement is rendered invalid or unenforceable by the enactment of any applicable statute or ordinance or by any regulation duly promulgated or is made or declared unenforceable by any court of competent jurisdiction, the remainder of this Agreement shall remain in full force and effect.

9.7 Attorneys’ Fees . In the event any attorney is employed by any Party with regard to any legal action, arbitration or other proceeding brought by any Party for the enforcement of

 

8


this Agreement, or because of an alleged dispute, breach, default or misrepresentation in connection with any of the provisions of this Agreement, then the prevailing Party, whether at trial or upon appeal, and in addition to any other relief to which the prevailing Party may be granted, shall be entitled to recover from the losing Party all costs, expenses and attorneys’ fees incurred by the prevailing Party in bringing or defending such action, arbitration or proceeding, and in enforcing any judgment granted therein, all of which costs, expenses and attorneys’ fees shall be deemed to have accrued upon the commencement of such action and shall be paid whether or not such action is prosecuted to judgment. Any judgment or order entered in such matter shall contain a specific provision providing for the recovery by the prevailing Party of attorneys’ fees, costs and expenses incurred in enforcing such judgment. For purposes of this Section 9.7 , attorneys’ fees shall include, without limitation, fees incurred in the following: post-judgment motions; contempt proceedings; garnishment, levy and debtor and third party examinations; discovery; and bankruptcy litigation.

9.8 Notices . All notices, requests, demands or other communications under this Agreement shall be in writing and shall be deemed to have been duly given on the date of service if served personally on the Party to whom notice is to be given, or on the third day after mailing if mailed to the Party to whom notice is to be given, by a recognized overnight carrier service, or by first class mail, registered or certified, postage prepaid, and properly addressed as follows:

 

TO PRACTICE:    San Diego Professional Group, P.C.
   731 South Highway 101, Suite 1-E
   Solano Beach, California 92075
   Attn: Mark A. Calarco, D.O.
TO COMPANY:    San Diego Addiction Treatment Center, Inc.
   2456 East Street
   San Diego, California 92102
   Attn.: Chief Executive Officer
WITH COPY TO:   
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Candance A. Henderson-Grice, Chief Operating Officer
   Email: chenderson-grice@contactaac.com
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Kathryn Sevier Phillips, General Counsel and Secretary
   Fax: (615) 691-7130
   Email: ksphillips@contactaac.com

Each Party may change its address indicated above by giving the other Party written notice of the new address in the manner set forth above.

 

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9.9 Governing Law . This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State. All actions, suits, or other proceedings with respect to this Agreement shall be brought only in a court of competent jurisdiction in the State. In any such action, suit, or proceeding, such court shall have personal jurisdiction over all of the parties hereto, and service of process upon them under any applicable statutes, laws, and rules shall be deemed valid and good.

9.10 Third Party Rights . This Agreement is entered into by and between the Parties hereto for their sole benefit. There is no intent by either Party to create or establish third party beneficiary status or rights in any third party to this Agreement and no third party shall have any right to enforce any right or enjoy any benefit created or established by this Agreement.

9.11 No Discrimination . No person shall be excluded from participation in, or be denied benefits of, or be otherwise subjected to discrimination in the performance of this Agreement or any Addenda on the grounds of disability, age, race, color, religion, sex, national origin or any other classification protected by federal and/or Tennessee constitutional, statutory and/or regulatory provisions.

9.12 Signatory . Each Party warrants that the person indicated on signatory line to this Agreement has all authority necessary to bind the Party and is the appropriate designated person to sign this Agreement.

9.13 Counterparts . This Agreement may be signed in multiple counterparts, each of which shall be deemed to be an original and all of which taken together shall constitute a single instrument.

9.14 Drafted Jointly . In the event of an ambiguity or question of intent or interpretation arises, this Agreement shall be construed as if drafted jointly by the Parties, and no presumption or burden of proof shall arise favoring or disfavoring any Party by virtue of authorship of the provisions of this Agreement.

9.15 Cooperation . The Parties agree to cooperate with each other to resolve promptly any outstanding financial, administrative or patient care issues upon the termination of this Agreement. Such obligation shall include, without limitation, the provision of patient, resident and/or administrative records, payments or other actions necessary to conclude the relationship of the Parties. This Section 9.15 shall survive the termination of this Agreement for any reason. Each Party further agrees to cooperate with the other to carry out the purpose and intent of this Agreement, including without limitation the execution and delivery to the appropriate Party of any further agreements and other documents and the taking of any action as may reasonably be required to effectuate the provisions of this Agreement.

[Signature Page Follows]

 

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IN WITNESS WHEREOF , the Parties hereto have duly executed this Agreement on the dates set forth below, provided that this Agreement is effective as of the Effective Date.

 

For Company:     For Practice:
San Diego Addiction Treatment Center, Inc.     San Diego Professional Group, P.C.
By:  

/s/ Michael T. Cartwright

    By:  

/s/ Mark A. Calarco, D.O.

Name:   Michael T. Cartwright     Name:   Mark A. Calarco, D.O.
Title:   Chairman and Chief Executive Officer     Title:   President, Secretary and Chief Financial Officer

 

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Schedule 2.1

Practice’s Services

Professional Services

During the term of this Agreement, Practice, through its physician shareholder, employees and independent contractors (the “ Medical Providers ”), shall provide professional medical services to the patients of Company (the “ Patients ”). Medical Providers may include doctors of medicine, doctors of osteopathy and mid-level providers including physician assistants and advanced practice nurses. Practice shall effectively provide all the professional medical services as required by Company for the needs of its Patients. Such professional medical services shall include those service obligations set forth herein and other related services reasonably requested by Company.

Medical Director Services

During the term of this Agreement, in addition to the professional services described above, Practice shall, unless otherwise agreed to by the parties, provide a physician who is acceptable to Company, to serve as medical director of Facility (the “ Medical Director ”) and provide medical management and oversight for matters specific to Facility pursuant to a medical director agreement between Practice and Medical Director reasonably acceptable to Company (the “ Medical Director Agreement ”). Practice shall cause Medical Director to furnish those services as set forth in the Medical Director Agreement, in accordance with the terms thereof. Upon request, Practice shall provide Company with documentation reasonably acceptable to Company supporting Medical Director’s fulfillment of such duties with Company also retaining the right to conduct such audits thereof as Company determines reasonably necessary to support Company’s payment for such services under this Agreement.

Practice shall provide support, assistance, and work cooperatively with Medical Director who will provide medical management and oversight for Facility. Practice, at the request of Company, shall immediately remove a Medical Director from Facility for cause, as “cause” is defined in Section 2.3.8 hereof.

The term “Medical Provider” as used in this Agreement shall include the Medical Director, provided that any provision that relates specifically to professional medical services will not apply to the Medical Director to the extent that the Medical Director is providing only administrative and not professional services.


Schedule 3.1

Compensation

Practice acknowledges that Practice may sometimes bill separately for the services of Medical Providers, and at other times Company submits global bills for the services of both the Facility and the Medical Providers. In light of the foregoing, Company shall pay to Practice the fees set forth below for services provided by the Medical Providers at the Facility to the extent that such provider services are not separately billed by Practice. To the extent Practice bills separately for Medical Provider services, Company shall not be obligated to pay a fee for such services.

 

Provider

  

Fee

Physician/Psychologist Clinical Services

   $125 - $ 175 per hour*

Medical Director Services

   $ 100 - $ 150 per hour*

Mid-level Provider Services (PA or NP)

   $ 55 - $ 95 per hour*

 

* Specific hourly rate within the noted range shall be determined by Company in its reasonable discretion after consultation with Practice, based on the experience level, specialty, certifications, and other qualifications of the applicable practitioner.

If Practice is asked by Company to provide additional practitioner services at the Facility, Company shall pay to Practice a fee for such services equal to the rate that Practice pays such provider for the services (unless the service is separately billable by Practice). Practice represents and warrants that the compensation it pays to Medical Providers, and the corresponding fees paid by Company, shall be reasonable and consistent with fair market value. Compensation shall be paid pursuant to Company’s standard payment policies and timing.


Schedule 7.2

HIPAA Business Associate Addendum

This HIPAA Business Associate Addendum (“ Addendum ”) amends and is made part of that certain Professional Services Agreement for Medical Staffing (“ Service Agreement ”), by and between San Diego Addiction Treatment Center, Inc. (“ Entity ”) and San Diego Professional Group, P.C. (“ Associate ”) to the extent that Associate is acting as a Business Associate of Entity.

Entity and Associate agree that the parties incorporate this Addendum into the Service Agreement in order to comply with the requirements of: the Health Insurance Portability and Accountability Act of 1996 (“ HIPAA ”), the Health Information Technology for Economic and Clinical Health Act (“ HITECH ”) and their implementing regulations set forth at 45 C.F.R. Parts 160 and Part 164 (the “ HIPAA Rules ”); and Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2 (“ Part 2 Regulations ”). To the extent Associate is acting as a Business Associate of Entity pursuant to the Service Agreement, the provisions of this Addendum shall apply, and Associate shall be subject to the penalty provisions of HIPAA as specified in 45 C.F.R. Part 160.

1. Definitions . Capitalized terms not otherwise defined in this Addendum shall have the meaning set forth in the HIPAA Rules. References to “PHI” mean Protected Health Information maintained, created, received or transmitted by Associate from Entity or on Entity’s behalf.

2. Uses or Disclosures . Associate will neither use nor disclose PHI except as permitted or required by this Addendum or as Required By Law. To the extent Associate is to carry out an obligation of Entity under the HIPAA Rules, Associate shall comply with the requirements of the HIPAA Rules that apply to Entity in the performance of such obligation. Without limiting the foregoing, Associate will not sell PHI or use or disclose PHI for purposes of marketing or fundraising, as defined and proscribed in the HIPAA Rules. Associate is permitted to use and disclose PHI:

(a) to perform any and all obligations of Associate as described in the Service Agreement, provided that such use or disclosure is consistent with the terms of Entity’s notice of privacy practices and would not violate the HIPAA Rules or the Part 2 Regulations, if done by Entity directly;

(b) to perform Data Aggregation services relating to the health care operations of Entity, provided that such services are part of Associate’s obligations as set forth in the Service Agreement;

(c) to create de-identified information in accordance with 45 C.F.R. § 164.514(b), provided that such de-identified information may be used and disclosed only consistent with applicable law; and

(d) as necessary for Associate’s proper management and administration and to carry out Associate’s legal responsibilities (collectively “ Associate’s Operations ”) provided that: any


disclosure made for purposes of Associate’s Operations is Required By Law or is made after Associate obtains reasonable assurances, evidenced by a written contract, from the recipient that the recipient: (i) will hold such PHI in confidence and use or further disclose it only for the purpose for which Associate disclosed it to the recipient or as Required By Law; (ii) will notify Associate of any instance of which the recipient becomes aware in which the confidentiality of such PHI was breached; (iii) acknowledges in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations; and (iv) agrees to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations. Associate shall promptly notify Entity of any disclosures made for purposes of Associate’s Operations.

In the event Entity notifies Associate of a restriction request that would restrict a use or disclosure otherwise permitted by this Addendum, Associate shall comply with the terms of the restriction request.

3. Safeguards . Associate will use appropriate administrative, technical and physical safeguards to prevent the use or disclosure of PHI other than as permitted by this Addendum and shall maintain policies and procedures to detect, prevent, and mitigate identity theft based on PHI or information derived from PHI. Associate will also comply with the provisions of 45 C.F.R. Part 164, Subpart C of the HIPAA Rules with respect to electronic PHI to prevent any use or disclosure of such information other than as provided by this Addendum, which obligation shall include maintaining safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI.

4. Policies and Training . Associate has policies in place regarding the confidential and secure treatment of PHI in accordance with HIPAA and the Part 2 Regulations. Associate shall require its employees to adhere to such policies and shall train its employees regarding the requirements of this Addendum and applicable confidentiality and security laws and regulations.

5. Subcontractors . In accordance with 45 C.F.R. § 164.308(b)(2) and 164.502(e)(1)(ii), Associate will ensure that all of its subcontractors that create, receive, maintain or transmit PHI on behalf of Associate agree by written contract to comply with the same restrictions and conditions that apply to Associate with respect to such PHI, including but not limited to (i) the obligation to safeguard PHI and comply with 45 C.F.R. Part 164, Subpart C; and (ii) acknowledging in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations, and must agree to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations.

6. Minimum Necessary . Associate represents that the PHI requested, used or disclosed by Associate shall be the minimum amount necessary to carry out the purposes of the Service Agreement. Associate will limit its uses and disclosures of, and requests for, PHI to the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request.

7. Obligations of Entity . Entity shall notify Associate of (i) any limitations in its notice of privacy practices, (ii) any changes in, or revocation of, permission by an individual to use or disclose PHI, and (iii) any confidential communication request or restriction on the use or disclosure of PHI that Entity has agreed to or with which Entity is required to comply, to the extent any of the foregoing affect Associate’s use or disclosure of PHI to perform its obligations as described in the Service Agreement.


8. Access and Amendment . In accordance with 45 C.F.R. § 164.524, Associate will permit Entity or, at Entity’s request, an individual (or the individual’s designee) to inspect and obtain copies of any PHI about the individual that is in Associate’s custody or control and that is maintained in a Designated Record Set. If the requested PHI is maintained electronically, Associate must provide a copy of the PHI in the electronic form and format requested by the individual, if it is readily producible, or, if not, in a readable electronic form and format as agreed to by Entity and the individual. Associate will notify Entity of any request (including but not limited to subpoenas) that Associate receives for access to PHI that is in Associate’s custody or control within five (5) business days of receipt of such request. Entity shall be responsible for making determinations about access. Associate will, upon receipt of notice from Entity, promptly amend or permit Entity access to amend any portion of the PHI that is in Associate’s custody or control so that Entity may meet its amendment obligations under 45 C.F.R. § 164.526.

9. Disclosure Accounting . Except for disclosures excluded from the accounting obligation by the HIPAA Rules and regulations issued pursuant to HITECH, Associate will record for each disclosure that Associate makes of PHI the information necessary for Entity to make an accounting of disclosures pursuant to the HIPAA Rules. In the event the U.S. Department of Health and Human Services (“ HHS ”) finalizes regulations requiring Covered Entities to provide access reports, Associate shall also record such information with respect to electronic PHI held by Associate as would be required under the regulations for Covered Entities beginning on the effective date applicable to Entity. Associate will make information required by this Section 9 available to Entity promptly upon Entity’s request for the period requested, but for no longer than the six (6) years preceding Entity’s request for the information or such other period required by the HIPAA Rules (except Associate need not have any information for disclosures occurring before the effective date of any previous HIPAA business associate agreements between the parties or, if none, the effective date of this Addendum).

10. Inspection of Books and Records . Associate will make its internal practices, books, and records, relating to its use and disclosure of PHI available upon request to Entity or HHS to determine Entity’s compliance with the HIPAA Rules.

11. Reporting . To the extent Associate becomes aware or discovers any use or disclosure of PHI not permitted by this Addendum, any Security Incident involving electronic PHI, any Breach of Unsecured Protected Health Information or any Red Flag (as defined at 16 C.F.R. § 681.2(b)) related to any individual who is the subject of PHI, Associate shall promptly report such use, disclosure, Security Incident, Breach or Red Flag to Entity. Associate shall mitigate, to the extent practicable, any harmful effect known to it of a Security Incident, Breach or use or disclosure of PHI by Associate not permitted by this Addendum. Notwithstanding the foregoing, the parties acknowledge and agree that this Section 11 constitutes notice by Associate to Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents (as defined below) for which no additional notice to Entity shall be required. “Unsuccessful Security Incidents” shall include, but not be limited to, pings and other broadcast attacks on Associate’s firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or


disclosure of electronic PHI. All reports of Breaches shall be made within ten (10) business days of Associate discovering the Breach and shall comply with and include the information specified at 45 C.F.R. § 164.410. Associate shall promptly reimburse Entity all reasonable costs incurred by Entity with respect to providing notification of and mitigating a Breach involving Associate, including but not limited to printing, postage costs and toll-free hotline costs.

12. Confidentiality of Alcohol and Drug Abuse Patient Records . Associate: (1) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from Entity about individuals who are patients of Entity (“ Patients ”), it is fully bound by the provisions of the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2; and (2) undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to Patients otherwise than as expressly provided for in the Part 2 Regulations.

13. Term and Termination . This Addendum shall be effective as of the effective date of the Service Agreement and shall remain in effect until termination of the Service Agreement. Either party may terminate this Addendum and the Service Agreement effective immediately if it determines that the other party has breached a material provision of this Addendum and failed to cure such breach within thirty (30) days of being notified by the other party of the breach. If the non-breaching party determines that cure is not possible, such party may terminate this Addendum and the Service Agreement effective immediately upon written notice to other party.

Upon termination of this Addendum for any reason, Associate will, if feasible, return to Entity or securely destroy all PHI maintained by Associate in any form or medium, including all copies of such PHI, at no cost to Entity. Further, Associate shall recover any PHI in the possession of its agents and subcontractors and return to Entity or securely destroy all such PHI. Notwithstanding the foregoing, Associate shall notify Entity and receive Entity’s written consent prior to destroying any PHI of which Entity does not maintain a duplicate copy. In the event that Associate determines that returning or destroying any PHI is infeasible, Associate shall promptly notify Entity of the conditions that make return or destruction infeasible. With regard to any PHI that Entity agrees cannot feasibly be returned to Entity or destroyed, Associate may maintain such PHI but shall continue to abide by the terms and conditions of this Addendum with respect to such PHI and shall limit its further use or disclosure of such PHI to those purposes that make return or destruction of the PHI infeasible. Associate shall comply with this Section 13 within thirty (30) days of termination of this Addendum. Associate shall provide Entity with written certification of its compliance with this Section 13 within forty-five (45) days of termination of this Addendum. Upon termination of this Addendum for any reason, all of Associate’s obligations under this Addendum shall survive termination and remain in effect (a) until Associate has completed the return or destruction of PHI as required by this Section 13 and (b) to the extent Associate retains any PHI pursuant to this Section 13 .

14. General Provisions . In the event that any final regulation or amendment to final regulations is promulgated by HHS or other government regulatory authority with respect to PHI, this Addendum will automatically be amended to remain in compliance with such regulations, and Associate shall promptly amend its contracts, if any, with subcontractors and agents to conform to the terms of this Addendum. Any ambiguity in this Addendum shall be resolved to permit Entity to comply with the HIPAA Rules and the Part 2 Regulations. Nothing


in this Addendum shall be construed to create any rights or remedies in any third parties or any agency relationship between the parties. A reference in this Addendum to a section in the HIPAA Rules or the Part 2 Regulations means the section as in effect or as amended. This Addendum replaces and supersedes and previous business associate agreements between the parties. The terms and conditions of this Addendum override and control any conflicting term or condition of the Service Agreement. To the extent Associate has limited its liability under the terms of the Service Agreement by a maximum recovery for direct damages, disclaimer against any consequential, indirect or punitive damages or any other limitation, all limitations shall exclude any damages to Entity arising from Associate’s breach of its obligations under this Addendum. All non-conflicting terms and conditions of the Service Agreement remain in full force and effect.

Exhibit 10.40

PROFESSIONAL SERVICES AGREEMENT

For Medical Staffing

THIS PROFESSIONAL SERVICES AGREEMENT for Medical Staffing (“ Agreement ”) is made this 5 th day of August, 2014 (the “ Effective Date ”), between San Diego Professional Group, P.C. (“ Practice ), a professional corporation organized under the laws of California, and Forterus Health Care Services, Inc., a Delaware corporation (“ Company ”) (individually, a “ Party ,” and, collectively, the “ Parties ”).

W I TN E S S E T H:

WHEREAS , Company has established and operates an addiction treatment facility, Forterus Health Care Services, Inc. (“ Facility ”), located at 41640 Corning Place, Murrieta, California 92562;

WHEREAS , Practice employs Medical Providers and other medical personnel specializing in the treatment of various addictions;

WHEREAS , Practice is owned by a physician licensed to practice medicine in the state of California (the “ State ”); and

WHEREAS , Company desires to engage Practice as of the Effective Date to provide, or arrange the provision of, medical services on behalf of Company, and Practice desires to accept such engagement as of the Effective Date, all upon the terms and conditions set forth in this Agreement.

NOW , THEREFORE , for and in consideration of the mutual agreements, covenants, terms and conditions herein contained, the Parties agree as follows:

ARTICLE I

ESTABLISHMENT OF PROFESSIONAL RELATIONSHIP

1.1 Engagement of Practice . As of the Effective Date, Company engages Practice, and Practice accepts said engagement, to provide medical services in accordance with the terms and conditions of this Agreement.

1.2 Relationship of the Parties . In the performance of their respective duties and obligations hereunder, the Parties are independent contractors, and as such they shall remain professionally and economically independent of each other. The Parties are not, and shall not be deemed to be, joint venturers, partners, employees, or agents of each other (except with respect to an agency for billing and collection activities expressly addressed in this Agreement). Neither Party shall have any authority to bind or incur any financial obligations on behalf of the other without the other’s express written consent, and then only insofar as such authority is conferred by such express written consent.


ARTICLE II

PRACTICE’S OBLIGATIONS

2.1 General Obligations . Practice shall provide the Medical Provider services set forth on Schedule 2.1 , attached hereto and incorporated herein by reference.

2.2 Responsibility for Medical Provider Services . Practice shall control and be responsible for the provision of medical services to Patients (as such term is defined on Schedule 2.1 ), and Company shall not engage in the practice of medicine nor shall it intervene or interfere in professional medical judgment of Practice or any Medical Provider; provided , however, that Practice shall cause the Medical Providers to comply with Company’s systems and procedures for review and improvement of the delivery of care.

2.3 Qualifications and Standards . Practice shall take all necessary actions to ensure that each Medical Provider satisfies the following conditions at all times during the Term:

2.3.1 Licensure and Experience Levels . Each Medical Provider shall maintain an unrestricted license to practice his or her specialty in the State and at all times shall be in good standing with the appropriate licensing board. Each Medical Provider shall have a level of competence, experience and skill at least comparable to that prevailing in the community.

2.3.2 Federal DEA Number . The Medical Providers shall maintain a Federal DEA number without restrictions, to the extent necessary for his or her practice.

2.3.3 Medical Standards . Each Medical Provider shall perform all medical services to be provided hereunder in accordance with the current standards of care in the medical community and any credentialing and quality criteria that are adopted from time to time by Company, the Facility and/or Practice

2.3.4 Continuing Education . Medical Providers shall participate in such continuing medical education and training programs as required by law to maintain skills compatible with standards of medical care in the community.

2.3.5 Bylaws . Medical Providers shall comply with any bylaws, policies, rules or regulations of Facility or Company, as may be amended from time to time.

2.3.6 Laws . Medical Providers shall comply with all applicable standards, rulings, regulations and requirements of the United States Department of Health and Human Services, the State’s department of health, the applicable accreditation agency of the Facility, and any federal, state or local government agency, third party payor or accrediting body having jurisdiction over or providing reimbursement for the Facility and any programs and services offered by either the Facility or Company.

2.3.7 Cooperation . Practice shall promptly notify Company if a claim of malpractice or professional discipline is asserted against any Medical Provider resulting from medical services provided at Facility; additionally Practice shall notify Company of claims not yet asserted against Medical Providers, but the potential for which Practice is aware.

 

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2.3.8 Approval and Removal . Each Medical Provider shall be subject to the initial approval of Company before he or she commences providing services at Facility. In addition, Practice, at the request of Company, shall immediately remove a Medical Provider from Facility for cause. For purposes of this Section 2.3.8 , “for cause” shall be determined by Company acting reasonably and in good faith and shall include the following: (a) suspension or revocation or other sanction of his or her medical license, specialty board certification, or Federal Drug Enforcement Agency (“ DEA ”) registration; (b) suspension, revocation, or reduction of his or her status or privileges as a member of the medical staff of any hospital utilized by Company for Patients served by the Medical Providers (including without limitation any resignation of membership or privileges in lieu of or to avoid any of the foregoing actions); (c) being arrested or indicted for, or convicted of any felony or any criminal charge relating to the practice of medicine; (d) being found by the appropriate licensure board or other state or federal regulatory agency to have violated any provision of law or the applicable code of medical ethics; (e) cancellation, termination or non-renewal of his or her professional liability insurance and failure to obtain replacement coverage within thirty (30) days; or (f) having committed any actions or inactions which pose an immediate and significant threat to Patients.

2.4 Compensation Responsibility . Practice shall be solely responsible for establishing and paying the compensation and fringe benefits, if any, to the Medical Providers. Practice shall be solely responsible for the payment and withholding of appropriate amounts for income tax, social security, unemployment insurance, and state disability insurance taxes. Practice shall also maintain in full force and effect all worker’s compensation insurance as may be required under the worker’s compensation laws of the State.

2.5 Medical Provider Staffing Levels . As of the Effective Date, Practice shall assign to Facility Medical Providers necessary to satisfy the patient needs at the Facility.

2.6 Authority . Practice has the right to enter into this Agreement, and neither the execution of this Agreement nor Practice’s performance hereunder will result in it being in breach or default of any existing agreement.

ARTICLE III

COMPENSATION

3.1 General Compensation Principles . Practice shall be compensated for the services provided hereunder pursuant to the terms of this Agreement as described in Schedule 3.1 , which is attached hereto and incorporated herein by reference. The Parties hereby acknowledge and agree that such amount represents the fair market value of the services provided hereunder.

ARTICLE IV

PATIENT CHARGES, BILLING AND COLLECTION

4.1 Billing; Assignment of Fees . Company, directly or through an affiliate, shall bill payors and patients for all technical and facility fees of the Facility. In addition, to the extent permissible by applicable law and third party payor policies, Company may (directly or through an affiliate) bill payors and patients globally for Company’s services and also the professional

 

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services of Practice and the Medical Providers that are provided pursuant to this Agreement. Practice authorizes Company, directly or through an affiliate, to bill and collect all professional fees of Practice and the Medical Providers, as Practice’s and the Medical Providers’ agent and attorney-in-fact to the extent permitted by applicable law for all services rendered by Practice or the Medical Providers at the Facility or on behalf of Company hereunder, either in Company’s own name or in Practice’s or individual Medical Provider’s name and provider number. Practice shall ensure that each Medical Provider executes such documentation as may be necessary to permit such billing by Company. To the extent that it is not allowable by law or payor policies for Company to bill for services on behalf of Practice or Medical Providers, Practice will bill in its own name for such services, provided that Practice intends to engage American Addiction Centers, Inc., an affiliate of Company, to provide billing support services. Practice shall ensure that duplicative billing does not occur, and neither it nor any Medical Provider will payors or patients for the same services that are billed by Company.

4.2 Practice to Provide Billing Information . For all applicable services described in Section 4.1 above and in accordance with applicable law, Practice shall provide Company with all billing information for services rendered by the Medical Providers, including, but not limited to, the name of the Patient, the date of service, the nature and extent of services provided, Patient diagnosis, and any supporting medical and non-medical information necessary to bill such services and to obtain payment and/or reimbursement. Each Medical Provider shall provide the above-described billing information to Company within seven (7) calendar days after the applicable medical services are rendered. The applicable treating Medical Provider shall be responsible for appropriately coding the service provided and supplying the correct CPT, KEY, ICD-9 (or ICD-10 once applicable) or other codes associated with the service.

ARTICLE V

INSURANCE

5.1 Comprehensive General Liability and Property Insurance . Company shall procure and maintain during the Term of this Agreement comprehensive general liability insurance covering its activities relating to Facility and property insurance covering the Facility. The comprehensive general liability insurance maintained hereunder shall be in amounts deemed sufficient by Company to protect against risks and losses associated with the operations of Facility.

5.2 Company’s Professional Liability Insurance . Company shall procure and maintain in full force and effect during the Term of this Agreement professional liability insurance covering Company and appropriate personnel provided by Company pursuant to this Agreement, including, without limitation, Company’s provider employees and contractors (subject to prior approval of insurer), against errors and omissions arising from Patient services and/or non-medical services rendered by Company pursuant to this Agreement. All premiums, costs and expenses associated with such professional liability insurance shall be borne by and paid by Company. The professional liability insurance procured by Company shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate. For purposes of Sections 5.1 and 5.2 , the term “insurance” shall include self-insurance arrangements maintained by Company for itself and its corporate affiliates, including Facility.

 

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5.3 Practice’s Professional Liability Insurance . Practice shall procure and maintain in full force and effect during the Term of this Agreement, and for a period of three (3) years subsequent to the expiration or earlier termination of this Agreement, professional liability insurance (i.e., medical malpractice insurance) with an insurer acceptable to Company, protecting Practice and its shareholders, officers, directors, and the Medical Providers against errors and omissions arising from professional services and/or medical services rendered by Practice and the Medical Providers. Such policy of insurance shall name Company as an additional insured. The insurance required by this Section 5.3 shall specifically extend to acts or omissions of Medical Providers occurring both prior and subsequent to the Effective Date. All premiums, costs and expenses associated with such professional liability insurance shall be borne by Practice. The professional liability insurance required by this Section 5.3 shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate.

5.4 Proof of Insurance . At the request of the other Party, each Party shall furnish copies of or Certificates of Insurance on all policies required under this Article V (or evidence of self-insurance) as evidence of the insurance coverage to be procured pursuant to this Agreement. In the case of Company, this evidence shall also specifically include evidence of “tail” or other coverage for acts and omissions occurring prior to the Effective Date. The insurance coverage required under this Agreement shall not be canceled, modified, reduced or otherwise materially changed, except upon thirty (30) days’ prior written notice to the non-procuring Party.

ARTICLE VI

INDEMNIFICATION

6.1 Indemnification by Company . Company shall indemnify, defend and hold Practice, and the shareholders, directors, officers and employees of Practice, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs, and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly from any negligent or willful act or omission of Company or its non-Medical Provider employees providing services at Facility. Notwithstanding any provisions of the preceding sentence to the contrary, Company shall not be liable to Practice for any consequential, exemplary or punitive damages. The duty of Company to indemnify, defend and hold harmless Practice shall only apply to the extent that any such loss sustained by Practice is not covered by insurance. The indemnification provisions of this Section 6.1 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other.

6.2 Indemnification by Practice . Practice shall indemnify, defend and hold Company, and the shareholders, directors, officers and employees of Company, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly, from any negligent or willful act or omission of any Medical Provider, including, specifically, (i) negligent or willful acts occurring both prior to and subsequent to the Effective Date and (ii) claims against Company attributable directly or indirectly to incorrect billing information provided to Company by Practice or any Medical Provider. Notwithstanding any provisions of the preceding sentence to the contrary, Practice shall not be liable to Company for any

 

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consequential, exemplary or punitive damages. The indemnification provisions of this Section 6.2 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other. A provision similar to that set forth in this Section 6.2 shall be contained in each contract between Practice and any independent contractor providing professional medical services for Practice at the Facility in order to ensure that each such Medical Provider has agreed to indemnify Company as required by this Section 6.2 .

ARTICLE VII

RECORDS AND CONFIDENTIALITY

7.1 Ownership of Records and Files . All business or medical records and files of whatever nature or kind, including Patients’ files and x-rays, are the property of Company to the extent permitted by law; neither Practice nor individual Medical Providers shall acquire any proprietary rights with respect to such records. However, at Practice’s written request, Company shall provide Medical Providers with copies of any records reflecting services performed by such Medical Provider with respect to (a) any claims against him/her in the nature of malpractice, (b) any charges against him/her issued by a licensing board or professional association or (c) for any other purpose deemed appropriate by Company

7.2 Confidentiality of Medical Records . Both Parties shall comply with all applicable federal and state laws and regulations regarding the confidential and secure treatment of individually identifiable health information, including 42 C.F.R. Part 2, and with the terms of the Business Associate Addendum attached as Schedule 7.2 hereto and incorporated herein by reference.

7.3 Medical Records upon Termination . Upon the expiration or earlier termination of this Agreement, unless a Patient specifies otherwise and in accordance with applicable law, Company shall be entitled to the original medical records for all Patients, and Practice shall be entitled to copy such records, with the cost of any copies to be home by Practice. For such period as is required by applicable statutes, Company shall keep possession of the original medical records and shall retain the records in their original condition, shall store the records in a safe place and make the records available to Practice without charge if reasonably necessary for any purpose, including, without limitation, Patient care and medical malpractice defense.

ARTICLE VIII

TERM AND TERMINATION

8.1 Term . This Agreement shall be effective for a term of five (5) years, beginning on the Effective Date, unless terminated pursuant to the provisions of this Article VIII (the “ Initial Term ”). Upon expiration of the Initial Term, this Agreement will automatically renew for additional one (1) year terms (the “ Renewal Terms ”) unless either Party shall provide notice to the other Party of its intent to terminate the Agreement under the terms of this Section 8.1 (“ Notice of Intent to Terminate ”). Notice of Intent to Terminate must be provided no later than one (1) year prior to the expiration of the Initial Term, and no later than ninety (90) days prior to the expiration of any Renewal Term.

 

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8.2 Termination upon Insolvency . If either Party shall apply for or consent to the appointment of a receiver, trustee or liquidation of itself, or if all or a substantial part of its assets, file a voluntary petition in bankruptcy or admit in writing its inability to pay its debts as they become due, make a general assignment for the benefit of creditors, file a petition or an answer seeking reorganization or arrangement with creditors, or take advantage of any insolvency law, or if an order, judgment, or decree shall be entered by a court of competent jurisdiction or an application of a creditor, adjudicating such party to be bankrupt or insolvent, or approving a petition seeking reorganization of such Party or appointing a receiver, trustee or liquidator of such Party or of all or a substantial part of its assets, and such order, judgment, or decree shall continue in effect and unstayed for a period of thirty (30) consecutive days, then the other Party may terminate this Agreement upon ten (10) days prior written notice to such Party.

8.3 Termination upon Legal Prohibitions of Relationship . If counsel jointly selected by the Parties should determine (the “ Determination ”) that it is more likely than not that applicable legislation, regulations, rules or procedures (collectively referred to herein as a “ Law ”) in effect or to become effective as of a date certain, or if Practice or Company receives notice (the “ Notice ”) of an actual or threatened decision, finding or action by any governmental or private agency or court (collectively referred to herein as an “ Action ”), which Law or Action, if or when implemented, would have the effect of subjecting either Party to civil or criminal prosecution under state and/or federal Laws, or other adverse proceeding on the basis of their participation herein, then the Parties shall attempt in good faith to amend this Agreement to the extent necessary in order to comply with such Law or to avoid the Action, as applicable. If, within ninety (90) days of providing written notice of such Determination or Notice to the other Party, the Parties acting in good faith are unable to mutually agree upon and make amendments or alterations to this Agreement to meet the requirements in question, or alternatively, the Parties mutually determine in good faith that compliance with such requirements is impossible or unfeasible, then this Agreement shall be terminated without penalty, charge or continuing liability upon the earlier of the following: the date one hundred eighty (180) days subsequent to the date upon which either Party gives written notice to the other Party or the effective date on which the Law or Action prohibits the relationship of the Parties pursuant to this Agreement.

8.4 Termination upon Breach . Either Party may elect to terminate this Agreement in the event that the other Party is in material breach of this Agreement and such default continues for a period of fifteen (15) calendar days after written notice thereof has been given to the Party in default by the other Party; provided , however, that Company may immediately terminate this Agreement if Practice fails to provide, or arrange the provision of, adequate professional medical services pursuant to this Agreement for a period of three (3) calendar days.

8.5 Termination Without Cause . This Agreement shall automatically terminate upon one hundred and eighty (180) days’ notice by either Party to the other Party.

8.6 Termination and Liabilities . In the event either Party validly elects to terminate this Agreement pursuant to the provisions of this Article VIII or the Agreement expires by its own terms, the liabilities and obligations of the Parties shall cease as of the date of termination, except that each Party shall be responsible for: (a) any payments or other obligations arising or accruing prior to the termination date and (b) any breach arising after termination or expiration with respect to obligations that continue after such expiration or termination. Neither Party shall

 

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be liable to the other for any damages resulting from any event of force majeure. The Parties agree that upon such termination, they will mutually work to assure an orderly transition of services.

ARTICLE IX

GENERAL PROVISIONS

9.1 Independence of Medical Judgment . Nothing in this Agreement shall affect the exercise of Medical Providers’ independent medical judgment.

9.2 Entire Agreement; Amendment . This Agreement constitutes the entire agreement between the Parties pertaining to the subject matter contained herein and supersedes all prior and contemporaneous agreements, representations and understandings of the Parties which relate to the subject matter of this Agreement. No supplement, amendment or modification of this Agreement shall be binding unless executed in writing by the Parties, unless otherwise provided herein.

9.3 No Waiver . No waiver of any of the provisions of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the Party making the waiver.

9.4 Subject Headings . The subject headings of the Articles and Sections of this Agreement are included for purposes of convenience only, and shall not affect the construction or interpretation of any of the provisions of this Agreement.

9.5 Binding Agreement; No Assignment . This Agreement shall be binding upon, and shall inure to the benefit of, the Parties and their respective legal representatives, successors and assigns. Company may assign this Agreement upon prior written notice to Practice. Practice may not assign this Agreement nor any rights hereunder, nor may it delegate any of the duties to be performed hereunder without the prior written consent of Company; provided , however, that notwithstanding the foregoing sentence to the contrary, Practice shall have the right to assign this Agreement to another corporate affiliate of Company upon written notice and shall have the right to subcontract with any other responsible parties, including specifically, corporate affiliates of Practice, for the performance of various aspects of its obligations hereunder, provided that Practice shall remain fully responsible for the performance of any such subcontractors.

9.6 Severability . Except as otherwise provided in Section 8.3 , in the event any provision of this Agreement is rendered invalid or unenforceable by the enactment of any applicable statute or ordinance or by any regulation duly promulgated or is made or declared unenforceable by any court of competent jurisdiction, the remainder of this Agreement shall remain in full force and effect.

9.7 Attorneys’ Fees . In the event any attorney is employed by any Party with regard to any legal action, arbitration or other proceeding brought by any Party for the enforcement of this Agreement, or because of an alleged dispute, breach, default or misrepresentation in connection with any of the provisions of this Agreement, then the prevailing Party, whether at trial or upon appeal, and in addition to any other relief to which the prevailing Party may be

 

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granted, shall be entitled to recover from the losing Party all costs, expenses and attorneys’ fees incurred by the prevailing Party in bringing or defending such action, arbitration or proceeding, and in enforcing any judgment granted therein, all of which costs, expenses and attorneys’ fees shall be deemed to have accrued upon the commencement of such action and shall be paid whether or not such action is prosecuted to judgment. Any judgment or order entered in such matter shall contain a specific provision providing for the recovery by the prevailing Party of attorneys’ fees, costs and expenses incurred in enforcing such judgment. For purposes of this Section 9.7 , attorneys’ fees shall include, without limitation, fees incurred in the following: post-judgment motions; contempt proceedings; garnishment, levy and debtor and third party examinations; discovery; and bankruptcy litigation.

9.8 Notices . All notices, requests, demands or other communications under this Agreement shall be in writing and shall be deemed to have been duly given on the date of service if served personally on the Party to whom notice is to be given, or on the third day after mailing if mailed to the Party to whom notice is to be given, by a recognized overnight carrier service, or by first class mail, registered or certified, postage prepaid, and properly addressed as follows:

 

TO PRACTICE:    San Diego Professional Group, P.C.
   731 South Highway 101, Suite 1-E
   Solano Beach, California 92075
   Attn: Mark A. Calarco, D.O.
TO COMPANY:    Forterus Health Care Services, Inc.
   41640 Corning Place
   Murrieta, California 92562
   Attn.: Chief Executive Officer
WITH COPY TO:   
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Candance A. Henderson-Grice, Chief Operating Officer
   Email: chenderson-grice@contactaac.com
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Kathryn Sevier Phillips, General Counsel and Secretary
   Fax: (615) 691-7130
   Email: ksphillips@contactaac.com

Each Party may change its address indicated above by giving the other Party written notice of the new address in the manner set forth above.

9.9 Governing Law . This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State. All actions, suits, or other proceedings with respect to this Agreement shall be brought only in a court of competent jurisdiction in the State.

 

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In any such action, suit, or proceeding, such court shall have personal jurisdiction over all of the parties hereto, and service of process upon them under any applicable statutes, laws, and rules shall be deemed valid and good.

9.10 Third Party Rights . This Agreement is entered into by and between the Parties hereto for their sole benefit. There is no intent by either Party to create or establish third party beneficiary status or rights in any third party to this Agreement and no third party shall have any right to enforce any right or enjoy any benefit created or established by this Agreement.

9.11 No Discrimination . No person shall be excluded from participation in, or be denied benefits of, or be otherwise subjected to discrimination in the performance of this Agreement or any Addenda on the grounds of disability, age, race, color, religion, sex, national origin or any other classification protected by federal and/or Tennessee constitutional, statutory and/or regulatory provisions.

9.12 Signatory . Each Party warrants that the person indicated on signatory line to this Agreement has all authority necessary to bind the Party and is the appropriate designated person to sign this Agreement.

9.13 Counterparts . This Agreement may be signed in multiple counterparts, each of which shall be deemed to be an original and all of which taken together shall constitute a single instrument.

9.14 Drafted Jointly . In the event of an ambiguity or question of intent or interpretation arises, this Agreement shall be construed as if drafted jointly by the Parties, and no presumption or burden of proof shall arise favoring or disfavoring any Party by virtue of authorship of the provisions of this Agreement.

9.15 Cooperation . The Parties agree to cooperate with each other to resolve promptly any outstanding financial, administrative or patient care issues upon the termination of this Agreement. Such obligation shall include, without limitation, the provision of patient, resident and/or administrative records, payments or other actions necessary to conclude the relationship of the Parties. This Section 9.15 shall survive the termination of this Agreement for any reason. Each Party further agrees to cooperate with the other to carry out the purpose and intent of this Agreement, including without limitation the execution and delivery to the appropriate Party of any further agreements and other documents and the taking of any action as may reasonably be required to effectuate the provisions of this Agreement.

[Signature Page Follows]

 

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IN WITNESS WHEREOF , the Parties hereto have duly executed this Agreement on the dates set forth below, provided that this Agreement is effective as of the Effective Date.

 

For Company:     For Practice:
Forterus Health Care Services, Inc.     San Diego Professional Group, P.C.
By:  

/s/ Michael T. Cartwright

    By:  

/s/ Mark A. Calarco, D.O.

Name:   Michael T. Cartwright     Name:   Mark A. Calarco, D.O.
Title:   Chairman and Chief Executive Officer     Title:   President, Secretary and Chief Financial Officer

 

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Schedule 2.1

Practice’s Services

Professional Services

During the term of this Agreement, Practice, through its physician shareholder, employees and independent contractors (the “ Medical Providers ”), shall provide professional medical services to the patients of Company (the “ Patients ”). Medical Providers may include doctors of medicine, doctors of osteopathy and mid-level providers including physician assistants and advanced practice nurses. Practice shall effectively provide all the professional medical services as required by Company for the needs of its Patients. Such professional medical services shall include those service obligations set forth herein and other related services reasonably requested by Company.

Medical Director Services

During the term of this Agreement, in addition to the professional services described above, Practice shall, unless otherwise agreed to by the parties, provide a physician who is acceptable to Company, to serve as medical director of Facility (the “ Medical Director ”) and provide medical management and oversight for matters specific to Facility pursuant to a medical director agreement between Practice and Medical Director reasonably acceptable to Company (the “ Medical Director Agreement ”). Practice shall cause Medical Director to furnish those services as set forth in the Medical Director Agreement, in accordance with the terms thereof. Upon request, Practice shall provide Company with documentation reasonably acceptable to Company supporting Medical Director’s fulfillment of such duties with Company also retaining the right to conduct such audits thereof as Company determines reasonably necessary to support Company’s payment for such services under this Agreement.

Practice shall provide support, assistance, and work cooperatively with Medical Director who will provide medical management and oversight for Facility. Practice, at the request of Company, shall immediately remove a Medical Director from Facility for cause, as “cause” is defined in Section 2.3.8 hereof.

The term “Medical Provider” as used in this Agreement shall include the Medical Director, provided that any provision that relates specifically to professional medical services will not apply to the Medical Director to the extent that the Medical Director is providing only administrative and not professional services.


Schedule 3.1

Compensation

Practice acknowledges that Practice may sometimes bill separately for the services of Medical Providers, and at other times Company submits global bills for the services of both the Facility and the Medical Providers. In light of the foregoing, Company shall pay to Practice the fees set forth below for services provided by the Medical Providers at the Facility to the extent that such provider services are not separately billed by Practice. To the extent Practice bills separately for Medical Provider services, Company shall not be obligated to pay a fee for such services.

 

Provider

   Fee

Physician/Psychologist Clinical Services

   $125 - $175 per hour*

Medical Director Services

   $100 - $150 per hour*

Mid-level Provider Services (PA or NP)

   $55 - $95 per hour*

 

* Specific hourly rate within the noted range shall be determined by Company in its reasonable discretion after consultation with Practice, based on the experience level, specialty, certifications, and other qualifications of the applicable practitioner.

If Practice is asked by Company to provide additional practitioner services at the Facility, Company shall pay to Practice a fee for such services equal to the rate that Practice pays such provider for the services (unless the service is separately billable by Practice). Practice represents and warrants that the compensation it pays to Medical Providers, and the corresponding fees paid by Company, shall be reasonable and consistent with fair market value. Compensation shall be paid pursuant to Company’s standard payment policies and timing.


Schedule 7.2

HIPAA Business Associate Addendum

This HIPAA Business Associate Addendum (“ Addendum ”) amends and is made part of that certain Professional Services Agreement for Medical Staffing (“ Service Agreement ”), by and between Forterus Healthcare Services, Inc. (“ Entity ”) and San Diego Professional Group, P.C. (“ Associate ”) to the extent that Associate is acting as a Business Associate of Entity.

Entity and Associate agree that the parties incorporate this Addendum into the Service Agreement in order to comply with the requirements of: the Health Insurance Portability and Accountability Act of 1996 (“ HIPAA ”), the Health Information Technology for Economic and Clinical Health Act (“ HITECH ”) and their implementing regulations set forth at 45 C.F.R. Parts 160 and Part 164 (the “ HIPAA Rules ”); and Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2 (“ Part 2 Regulations ”). To the extent Associate is acting as a Business Associate of Entity pursuant to the Service Agreement, the provisions of this Addendum shall apply, and Associate shall be subject to the penalty provisions of HIPAA as specified in 45 C.F.R. Part 160.

1. Definitions . Capitalized terms not otherwise defined in this Addendum shall have the meaning set forth in the HIPAA Rules. References to “PHI” mean Protected Health Information maintained, created, received or transmitted by Associate from Entity or on Entity’s behalf.

2. Uses or Disclosures . Associate will neither use nor disclose PHI except as permitted or required by this Addendum or as Required By Law. To the extent Associate is to carry out an obligation of Entity under the HIPAA Rules, Associate shall comply with the requirements of the HIPAA Rules that apply to Entity in the performance of such obligation. Without limiting the foregoing, Associate will not sell PHI or use or disclose PHI for purposes of marketing or fundraising, as defined and proscribed in the HIPAA Rules. Associate is permitted to use and disclose PHI:

(a) to perform any and all obligations of Associate as described in the Service Agreement, provided that such use or disclosure is consistent with the terms of Entity’s notice of privacy practices and would not violate the HIPAA Rules or the Part 2 Regulations, if done by Entity directly;

(b) to perform Data Aggregation services relating to the health care operations of Entity, provided that such services are part of Associate’s obligations as set forth in the Service Agreement;

(c) to create de-identified information in accordance with 45 C.F.R. § 164.514(b), provided that such de-identified information may be used and disclosed only consistent with applicable law; and

(d) as necessary for Associate’s proper management and administration and to carry out Associate’s legal responsibilities (collectively “ Associate’s Operations ”) provided that: any disclosure made for purposes of Associate’s Operations is Required By Law or is made after


Associate obtains reasonable assurances, evidenced by a written contract, from the recipient that the recipient: (i) will hold such PHI in confidence and use or further disclose it only for the purpose for which Associate disclosed it to the recipient or as Required By Law; (ii) will notify Associate of any instance of which the recipient becomes aware in which the confidentiality of such PHI was breached; (iii) acknowledges in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations; and (iv) agrees to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations. Associate shall promptly notify Entity of any disclosures made for purposes of Associate’s Operations.

In the event Entity notifies Associate of a restriction request that would restrict a use or disclosure otherwise permitted by this Addendum, Associate shall comply with the terms of the restriction request.

3. Safeguards . Associate will use appropriate administrative, technical and physical safeguards to prevent the use or disclosure of PHI other than as permitted by this Addendum and shall maintain policies and procedures to detect, prevent, and mitigate identity theft based on PHI or information derived from PHI. Associate will also comply with the provisions of 45 C.F.R. Part 164, Subpart C of the HIPAA Rules with respect to electronic PHI to prevent any use or disclosure of such information other than as provided by this Addendum, which obligation shall include maintaining safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI.

4. Policies and Training . Associate has policies in place regarding the confidential and secure treatment of PHI in accordance with HIPAA and the Part 2 Regulations. Associate shall require its employees to adhere to such policies and shall train its employees regarding the requirements of this Addendum and applicable confidentiality and security laws and regulations.

5. Subcontractors . In accordance with 45 C.F.R. § 164.308(b)(2) and 164.502(e)(1)(ii), Associate will ensure that all of its subcontractors that create, receive, maintain or transmit PHI on behalf of Associate agree by written contract to comply with the same restrictions and conditions that apply to Associate with respect to such PHI, including but not limited to (i) the obligation to safeguard PHI and comply with 45 C.F.R. Part 164, Subpart C; and (ii) acknowledging in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations, and must agree to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations.

6. Minimum Necessary . Associate represents that the PHI requested, used or disclosed by Associate shall be the minimum amount necessary to carry out the purposes of the Service Agreement. Associate will limit its uses and disclosures of, and requests for, PHI to the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request.

7. Obligations of Entity . Entity shall notify Associate of (i) any limitations in its notice of privacy practices, (ii) any changes in, or revocation of, permission by an individual to use or disclose PHI, and (iii) any confidential communication request or restriction on the use or disclosure of PHI that Entity has agreed to or with which Entity is required to comply, to the extent any of the foregoing affect Associate’s use or disclosure of PHI to perform its obligations as described in the Service Agreement.


8. Access and Amendment . In accordance with 45 C.F.R. § 164.524, Associate will permit Entity or, at Entity’s request, an individual (or the individual’s designee) to inspect and obtain copies of any PHI about the individual that is in Associate’s custody or control and that is maintained in a Designated Record Set. If the requested PHI is maintained electronically, Associate must provide a copy of the PHI in the electronic form and format requested by the individual, if it is readily producible, or, if not, in a readable electronic form and format as agreed to by Entity and the individual. Associate will notify Entity of any request (including but not limited to subpoenas) that Associate receives for access to PHI that is in Associate’s custody or control within five (5) business days of receipt of such request. Entity shall be responsible for making determinations about access. Associate will, upon receipt of notice from Entity, promptly amend or permit Entity access to amend any portion of the PHI that is in Associate’s custody or control so that Entity may meet its amendment obligations under 45 C.F.R. § 164.526.

9. Disclosure Accounting . Except for disclosures excluded from the accounting obligation by the HIPAA Rules and regulations issued pursuant to HITECH, Associate will record for each disclosure that Associate makes of PHI the information necessary for Entity to make an accounting of disclosures pursuant to the HIPAA Rules. In the event the U.S. Department of Health and Human Services (“ HHS ”) finalizes regulations requiring Covered Entities to provide access reports, Associate shall also record such information with respect to electronic PHI held by Associate as would be required under the regulations for Covered Entities beginning on the effective date applicable to Entity. Associate will make information required by this Section 9 available to Entity promptly upon Entity’s request for the period requested, but for no longer than the six (6) years preceding Entity’s request for the information or such other period required by the HIPAA Rules (except Associate need not have any information for disclosures occurring before the effective date of any previous HIPAA business associate agreements between the parties or, if none, the effective date of this Addendum).

10. Inspection of Books and Records . Associate will make its internal practices, books, and records, relating to its use and disclosure of PHI available upon request to Entity or HHS to determine Entity’s compliance with the HIPAA Rules.

11. Reporting . To the extent Associate becomes aware or discovers any use or disclosure of PHI not permitted by this Addendum, any Security Incident involving electronic PHI, any Breach of Unsecured Protected Health Information or any Red Flag (as defined at 16 C.F.R. § 681.2(b)) related to any individual who is the subject of PHI, Associate shall promptly report such use, disclosure, Security Incident, Breach or Red Flag to Entity. Associate shall mitigate, to the extent practicable, any harmful effect known to it of a Security Incident, Breach or use or disclosure of PHI by Associate not permitted by this Addendum. Notwithstanding the foregoing, the parties acknowledge and agree that this Section 11 constitutes notice by Associate to Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents (as defined below) for which no additional notice to Entity shall be required. “Unsuccessful Security Incidents” shall include, but not be limited to, pings and other broadcast attacks on Associate’s firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or


disclosure of electronic PHI. All reports of Breaches shall be made within ten (10) business days of Associate discovering the Breach and shall comply with and include the information specified at 45 C.F.R. § 164.410. Associate shall promptly reimburse Entity all reasonable costs incurred by Entity with respect to providing notification of and mitigating a Breach involving Associate, including but not limited to printing, postage costs and toll-free hotline costs.

12. Confidentiality of Alcohol and Drug Abuse Patient Records . Associate: (1) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from Entity about individuals who are patients of Entity (“ Patients ”), it is fully bound by the provisions of the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2; and (2) undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to Patients otherwise than as expressly provided for in the Part 2 Regulations.

13. Term and Termination . This Addendum shall be effective as of the effective date of the Service Agreement and shall remain in effect until termination of the Service Agreement. Either party may terminate this Addendum and the Service Agreement effective immediately if it determines that the other party has breached a material provision of this Addendum and failed to cure such breach within thirty (30) days of being notified by the other party of the breach. If the non-breaching party determines that cure is not possible, such party may terminate this Addendum and the Service Agreement effective immediately upon written notice to other party.

Upon termination of this Addendum for any reason, Associate will, if feasible, return to Entity or securely destroy all PHI maintained by Associate in any form or medium, including all copies of such PHI, at no cost to Entity. Further, Associate shall recover any PHI in the possession of its agents and subcontractors and return to Entity or securely destroy all such PHI. Notwithstanding the foregoing, Associate shall notify Entity and receive Entity’s written consent prior to destroying any PHI of which Entity does not maintain a duplicate copy. In the event that Associate determines that returning or destroying any PHI is infeasible, Associate shall promptly notify Entity of the conditions that make return or destruction infeasible. With regard to any PHI that Entity agrees cannot feasibly be returned to Entity or destroyed, Associate may maintain such PHI but shall continue to abide by the terms and conditions of this Addendum with respect to such PHI and shall limit its further use or disclosure of such PHI to those purposes that make return or destruction of the PHI infeasible. Associate shall comply with this Section 13 within thirty (30) days of termination of this Addendum. Associate shall provide Entity with written certification of its compliance with this Section 13 within forty-five (45) days of termination of this Addendum. Upon termination of this Addendum for any reason, all of Associate’s obligations under this Addendum shall survive termination and remain in effect (a) until Associate has completed the return or destruction of PHI as required by this Section 13 and (b) to the extent Associate retains any PHI pursuant to this Section 13 .

14. General Provisions . In the event that any final regulation or amendment to final regulations is promulgated by HHS or other government regulatory authority with respect to PHI, this Addendum will automatically be amended to remain in compliance with such regulations, and Associate shall promptly amend its contracts, if any, with subcontractors and agents to conform to the terms of this Addendum. Any ambiguity in this Addendum shall be resolved to permit Entity to comply with the HIPAA Rules and the Part 2 Regulations. Nothing


in this Addendum shall be construed to create any rights or remedies in any third parties or any agency relationship between the parties. A reference in this Addendum to a section in the HIPAA Rules or the Part 2 Regulations means the section as in effect or as amended. This Addendum replaces and supersedes and previous business associate agreements between the parties. The terms and conditions of this Addendum override and control any conflicting term or condition of the Service Agreement. To the extent Associate has limited its liability under the terms of the Service Agreement by a maximum recovery for direct damages, disclaimer against any consequential, indirect or punitive damages or any other limitation, all limitations shall exclude any damages to Entity arising from Associate’s breach of its obligations under this Addendum. All non-conflicting terms and conditions of the Service Agreement remain in full force and effect.

Exhibit 10.41

PROFESSIONAL SERVICES AGREEMENT

For Medical Staffing

THIS PROFESSIONAL SERVICES AGREEMENT for Medical Staffing (“ Agreement ”) is made this 5 th day of August, 2014 (the “ Effective Date ”), between Palm Beach Professional Group, Professional Corporation (“ Practice ”), a professional corporation organized under the laws of Florida, and Singer Island Recovery Center LLC, a Florida limited liability company (“ Company ”) (individually, a “ Party ,” and, collectively, the “ Parties ”).

W I TN E S S E T H:

WHEREAS , Company has established and operates an addiction treatment facility, Singer Island Recovery Center LLC (“ Facility ”), located at 4460 Medical Center Way, West Palm Beach, Florida 33407;

WHEREAS , Practice employs Medical Providers and other medical personnel specializing in the treatment of various addictions;

WHEREAS , Practice is owned by a physician licensed to practice medicine in the state of Florida (the “ State ”); and

WHEREAS , Company desires to engage Practice as of the Effective Date to provide, or arrange the provision of, medical services on behalf of Company, and Practice desires to accept such engagement as of the Effective Date, all upon the terms and conditions set forth in this Agreement.

NOW , THEREFORE , for and in consideration of the mutual agreements, covenants, terms and conditions herein contained, the Parties agree as follows:

ARTICLE I

ESTABLISHMENT OF PROFESSIONAL RELATIONSHIP

1.1 Engagement of Practice . As of the Effective Date, Company engages Practice, and Practice accepts said engagement, to provide medical services in accordance with the terms and conditions of this Agreement.

1.2 Relationship of the Parties . In the performance of their respective duties and obligations hereunder, the Parties are independent contractors, and as such they shall remain professionally and economically independent of each other. The Parties are not, and shall not be deemed to be, joint venturers, partners, employees, or agents of each other (except with respect to an agency for billing and collection activities expressly addressed in this Agreement). Neither Party shall have any authority to bind or incur any financial obligations on behalf of the other without the other’s express written consent, and then only insofar as such authority is conferred by such express written consent.


ARTICLE II

PRACTICE’S OBLIGATIONS

2.1 General Obligations . Practice shall provide the Medical Provider services set forth on Schedule 2.1 , attached hereto and incorporated herein by reference.

2.2 Responsibility for Medical Provider Services . Practice shall control and be responsible for the provision of medical services to Patients (as such term is defined on Schedule 2.1 ), and Company shall not engage in the practice of medicine nor shall it intervene or interfere in professional medical judgment of Practice or any Medical Provider; provided , however, that Practice shall cause the Medical Providers to comply with Company’s systems and procedures for review and improvement of the delivery of care.

2.3 Qualifications and Standards . Practice shall take all necessary actions to ensure that each Medical Provider satisfies the following conditions at all times during the Term:

2.3.1 Licensure and Experience Levels . Each Medical Provider shall maintain an unrestricted license to practice his or her specialty in the State and at all times shall be in good standing with the appropriate licensing board. Each Medical Provider shall have a level of competence, experience and skill at least comparable to that prevailing in the community.

2.3.2 Federal DEA Number . The Medical Providers shall maintain a Federal DEA number without restrictions, to the extent necessary for his or her practice.

2.3.3 Medical Standards . Each Medical Provider shall perform all medical services to be provided hereunder in accordance with the current standards of care in the medical community and any credentialing and quality criteria that are adopted from time to time by Company, the Facility and/or Practice

2.3.4 Continuing Education . Medical Providers shall participate in such continuing medical education and training programs as required by law to maintain skills compatible with standards of medical care in the community.

2.3.5 Bylaws . Medical Providers shall comply with any bylaws, policies, rules or regulations of Facility or Company, as may be amended from time to time.

2.3.6 Laws . Medical Providers shall comply with all applicable standards, rulings, regulations and requirements of the United States Department of Health and Human Services, the State’s department of health, the applicable accreditation agency of the Facility, and any federal, state or local government agency, third party payor or accrediting body having jurisdiction over or providing reimbursement for the Facility and any programs and services offered by either the Facility or Company.

2.3.7 Cooperation . Practice shall promptly notify Company if a claim of malpractice or professional discipline is asserted against any Medical Provider resulting from medical services provided at Facility; additionally Practice shall notify Company of claims not yet asserted against Medical Providers, but the potential for which Practice is aware.

 

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2.3.8 Approval and Removal . Each Medical Provider shall be subject to the initial approval of Company before he or she commences providing services at Facility. In addition, Practice, at the request of Company, shall immediately remove a Medical Provider from Facility for cause. For purposes of this Section 2.3.8 , “for cause” shall be determined by Company acting reasonably and in good faith and shall include the following: (a) suspension or revocation or other sanction of his or her medical license, specialty board certification, or Federal Drug Enforcement Agency (“ DEA ”) registration; (b) suspension, revocation, or reduction of his or her status or privileges as a member of the medical staff of any hospital utilized by Company for Patients served by the Medical Providers (including without limitation any resignation of membership or privileges in lieu of or to avoid any of the foregoing actions); (c) being arrested or indicted for, or convicted of any felony or any criminal charge relating to the practice of medicine; (d) being found by the appropriate licensure board or other state or federal regulatory agency to have violated any provision of law or the applicable code of medical ethics; (e) cancellation, termination or non-renewal of his or her professional liability insurance and failure to obtain replacement coverage within thirty (30) days; or (f) having committed any actions or inactions which pose an immediate and significant threat to Patients.

2.4 Compensation Responsibility . Practice shall be solely responsible for establishing and paying the compensation and fringe benefits, if any, to the Medical Providers. Practice shall be solely responsible for the payment and withholding of appropriate amounts for income tax, social security, unemployment insurance, and state disability insurance taxes. Practice shall also maintain in full force and effect all worker’s compensation insurance as may be required under the worker’s compensation laws of the State.

2.5 Medical Provider Staffing Levels . As of the Effective Date, Practice shall assign to Facility Medical Providers necessary to satisfy the patient needs at the Facility.

2.6 Authority . Practice has the right to enter into this Agreement, and neither the execution of this Agreement nor Practice’s performance hereunder will result in it being in breach or default of any existing agreement.

ARTICLE III

COMPENSATION

3.1 General Compensation Principles . Practice shall be compensated for the services provided hereunder pursuant to the terms of this Agreement as described in Schedule 3.1 , which is attached hereto and incorporated herein by reference. The Parties hereby acknowledge and agree that such amount represents the fair market value of the services provided hereunder.

ARTICLE IV

PATIENT CHARGES, BILLING AND COLLECTION

4.1 Billing; Assignment of Fees . Company, directly or through an affiliate, shall bill payors and patients for all technical and facility fees of the Facility. In addition, to the extent permissible by applicable law and third party payor policies, Company may (directly or through an affiliate) bill payors and patients globally for Company’s services and also the professional

 

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services of Practice and the Medical Providers that are provided pursuant to this Agreement. Practice authorizes Company, directly or through an affiliate, to bill and collect all professional fees of Practice and the Medical Providers, as Practice’s and the Medical Providers’ agent and attorney-in-fact to the extent permitted by applicable law for all services rendered by Practice or the Medical Providers at the Facility or on behalf of Company hereunder, either in Company’s own name or in Practice’s or individual Medical Provider’s name and provider number. Practice shall ensure that each Medical Provider executes such documentation as may be necessary to permit such billing by Company. To the extent that it is not allowable by law or payor policies for Company to bill for services on behalf of Practice or Medical Providers, Practice will bill in its own name for such services, provided that Practice intends to engage American Addiction Centers, Inc., an affiliate of Company, to provide billing support services. Practice shall ensure that duplicative billing does not occur, and neither it nor any Medical Provider will payors or patients for the same services that are billed by Company.

4.2 Practice to Provide Billing Information . For all applicable services described in Section 4.1 above and in accordance with applicable law, Practice shall provide Company with all billing information for services rendered by the Medical Providers, including, but not limited to, the name of the Patient, the date of service, the nature and extent of services provided, Patient diagnosis, and any supporting medical and non-medical information necessary to bill such services and to obtain payment and/or reimbursement. Each Medical Provider shall provide the above-described billing information to Company within seven (7) calendar days after the applicable medical services are rendered. The applicable treating Medical Provider shall be responsible for appropriately coding the service provided and supplying the correct CPT, KEY, ICD-9 (or ICD-10 once applicable) or other codes associated with the service.

ARTICLE V

INSURANCE

5.1 Comprehensive General Liability and Property Insurance . Company shall procure and maintain during the Term of this Agreement comprehensive general liability insurance covering its activities relating to Facility and property insurance covering the Facility. The comprehensive general liability insurance maintained hereunder shall be in amounts deemed sufficient by Company to protect against risks and losses associated with the operations of Facility.

5.2 Company’s Professional Liability Insurance . Company shall procure and maintain in full force and effect during the Term of this Agreement professional liability insurance covering Company and appropriate personnel provided by Company pursuant to this Agreement, including, without limitation, Company’s provider employees and contractors (subject to prior approval of insurer), against errors and omissions arising from Patient services and/or non-medical services rendered by Company pursuant to this Agreement. All premiums, costs and expenses associated with such professional liability insurance shall be borne by and paid by Company. The professional liability insurance procured by Company shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate. For purposes of Sections 5.1 and 5.2 , the term “insurance” shall include self-insurance arrangements maintained by Company for itself and its corporate affiliates, including Facility.

 

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5.3 Practice’s Professional Liability Insurance . Practice shall procure and maintain in full force and effect during the Term of this Agreement, and for a period of three (3) years subsequent to the expiration or earlier termination of this Agreement, professional liability insurance (i.e., medical malpractice insurance) with an insurer acceptable to Company, protecting Practice and its shareholders, officers, directors, and the Medical Providers against errors and omissions arising from professional services and/or medical services rendered by Practice and the Medical Providers. Such policy of insurance shall name Company as an additional insured. The insurance required by this Section 5.3 shall specifically extend to acts or omissions of Medical Providers occurring both prior and subsequent to the Effective Date. All premiums, costs and expenses associated with such professional liability insurance shall be borne by Practice. The professional liability insurance required by this Section 5.3 shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate.

5.4 Proof of Insurance . At the request of the other Party, each Party shall furnish copies of or Certificates of Insurance on all policies required under this Article V (or evidence of self-insurance) as evidence of the insurance coverage to be procured pursuant to this Agreement. In the case of Company, this evidence shall also specifically include evidence of “tail” or other coverage for acts and omissions occurring prior to the Effective Date. The insurance coverage required under this Agreement shall not be canceled, modified, reduced or otherwise materially changed, except upon thirty (30) days’ prior written notice to the non-procuring Party.

ARTICLE VI

INDEMNIFICATION

6.1 Indemnification by Company . Company shall indemnify, defend and hold Practice, and the shareholders, directors, officers and employees of Practice, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs, and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly from any negligent or willful act or omission of Company or its non-Medical Provider employees providing services at Facility. Notwithstanding any provisions of the preceding sentence to the contrary, Company shall not be liable to Practice for any consequential, exemplary or punitive damages. The duty of Company to indemnify, defend and hold harmless Practice shall only apply to the extent that any such loss sustained by Practice is not covered by insurance. The indemnification provisions of this Section 6.1 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other.

6.2 Indemnification by Practice . Practice shall indemnify, defend and hold Company, and the shareholders, directors, officers and employees of Company, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly, from any negligent or willful act or omission of any Medical Provider, including, specifically, (i) negligent or willful acts occurring both prior to and subsequent to the Effective Date and (ii) claims against Company attributable directly or indirectly to incorrect billing information provided to Company by Practice or any Medical Provider. Notwithstanding any provisions of the preceding sentence to the contrary, Practice shall not be liable to Company for any

 

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consequential, exemplary or punitive damages. The indemnification provisions of this Section 6.2 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other. A provision similar to that set forth in this Section 6.2 shall be contained in each contract between Practice and any independent contractor providing professional medical services for Practice at the Facility in order to ensure that each such Medical Provider has agreed to indemnify Company as required by this Section 6.2 .

ARTICLE VII

RECORDS AND CONFIDENTIALITY

7.1 Ownership of Records and Files . All business or medical records and files of whatever nature or kind, including Patients’ files and x-rays, are the property of Company to the extent permitted by law; neither Practice nor individual Medical Providers shall acquire any proprietary rights with respect to such records. However, at Practice’s written request, Company shall provide Medical Providers with copies of any records reflecting services performed by such Medical Provider with respect to (a) any claims against him/her in the nature of malpractice, (b) any charges against him/her issued by a licensing board or professional association or (c) for any other purpose deemed appropriate by Company

7.2 Confidentiality of Medical Records . Both Parties shall comply with all applicable federal and state laws and regulations regarding the confidential and secure treatment of individually identifiable health information, including 42 C.F.R. Part 2, and with the terms of the Business Associate Addendum attached as Schedule 7.2 hereto and incorporated herein by reference.

7.3 Medical Records upon Termination . Upon the expiration or earlier termination of this Agreement, unless a Patient specifies otherwise and in accordance with applicable law, Company shall be entitled to the original medical records for all Patients, and Practice shall be entitled to copy such records, with the cost of any copies to be home by Practice. For such period as is required by applicable statutes, Company shall keep possession of the original medical records and shall retain the records in their original condition, shall store the records in a safe place and make the records available to Practice without charge if reasonably necessary for any purpose, including, without limitation, Patient care and medical malpractice defense.

ARTICLE VIII

TERM AND TERMINATION

8.1 Term . This Agreement shall be effective for a term of five (5) years, beginning on the Effective Date, unless terminated pursuant to the provisions of this Article VIII (the “ Initial Term ”). Upon expiration of the Initial Term, this Agreement will automatically renew for additional one (1) year terms (the “ Renewal Terms ”) unless either Party shall provide notice to the other Party of its intent to terminate the Agreement under the terms of this Section 8.1 (“ Notice of Intent to Terminate ”). Notice of Intent to Terminate must be provided no later than one (1) year prior to the expiration of the Initial Term, and no later than ninety (90) days prior to the expiration of any Renewal Term.

 

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8.2 Termination upon Insolvency . If either Party shall apply for or consent to the appointment of a receiver, trustee or liquidation of itself, or if all or a substantial part of its assets, file a voluntary petition in bankruptcy or admit in writing its inability to pay its debts as they become due, make a general assignment for the benefit of creditors, file a petition or an answer seeking reorganization or arrangement with creditors, or take advantage of any insolvency law, or if an order, judgment, or decree shall be entered by a court of competent jurisdiction or an application of a creditor, adjudicating such party to be bankrupt or insolvent, or approving a petition seeking reorganization of such Party or appointing a receiver, trustee or liquidator of such Party or of all or a substantial part of its assets, and such order, judgment, or decree shall continue in effect and unstayed for a period of thirty (30) consecutive days, then the other Party may terminate this Agreement upon ten (10) days prior written notice to such Party.

8.3 Termination upon Legal Prohibitions of Relationship . If counsel jointly selected by the Parties should determine (the “Determination”) that it is more likely than not that applicable legislation, regulations, rules or procedures (collectively referred to herein as a “ Law ”) in effect or to become effective as of a date certain, or if Practice or Company receives notice (the “ Notice ”) of an actual or threatened decision, finding or action by any governmental or private agency or court (collectively referred to herein as an “ Action ”), which Law or Action, if or when implemented, would have the effect of subjecting either Party to civil or criminal prosecution under state and/or federal Laws, or other adverse proceeding on the basis of their participation herein, then the Parties shall attempt in good faith to amend this Agreement to the extent necessary in order to comply with such Law or to avoid the Action, as applicable. If, within ninety (90) days of providing written notice of such Determination or Notice to the other Party, the Parties acting in good faith are unable to mutually agree upon and make amendments or alterations to this Agreement to meet the requirements in question, or alternatively, the Parties mutually determine in good faith that compliance with such requirements is impossible or unfeasible, then this Agreement shall be terminated without penalty, charge or continuing liability upon the earlier of the following: the date one hundred eighty (180) days subsequent to the date upon which either Party gives written notice to the other Party or the effective date on which the Law or Action prohibits the relationship of the Parties pursuant to this Agreement.

8.4 Termination upon Breach . Either Party may elect to terminate this Agreement in the event that the other Party is in material breach of this Agreement and such default continues for a period of fifteen (15) calendar days after written notice thereof has been given to the Party in default by the other Party; provided , however, that Company may immediately terminate this Agreement if Practice fails to provide, or arrange the provision of, adequate professional medical services pursuant to this Agreement for a period of three (3) calendar days.

8.5 Termination Without Cause . This Agreement shall automatically terminate upon one hundred and eighty (180) days’ notice by either Party to the other Party.

8.6 Termination and Liabilities . In the event either Party validly elects to terminate this Agreement pursuant to the provisions of this Article VIII or the Agreement expires by its own terms, the liabilities and obligations of the Parties shall cease as of the date of termination, except that each Party shall be responsible for: (a) any payments or other obligations arising or accruing prior to the termination date and (b) any breach arising after termination or expiration with respect to obligations that continue after such expiration or termination. Neither Party shall

 

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be liable to the other for any damages resulting from any event of force majeure. The Parties agree that upon such termination, they will mutually work to assure an orderly transition of services.

ARTICLE IX

GENERAL PROVISIONS

9.1 Independence of Medical Judgment . Nothing in this Agreement shall affect the exercise of Medical Providers’ independent medical judgment.

9.2 Entire Agreement; Amendment . This Agreement constitutes the entire agreement between the Parties pertaining to the subject matter contained herein and supersedes all prior and contemporaneous agreements, representations and understandings of the Parties which relate to the subject matter of this Agreement. No supplement, amendment or modification of this Agreement shall be binding unless executed in writing by the Parties, unless otherwise provided herein.

9.3 No Waiver . No waiver of any of the provisions of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the Party making the waiver.

9.4 Subject Headings . The subject headings of the Articles and Sections of this Agreement are included for purposes of convenience only, and shall not affect the construction or interpretation of any of the provisions of this Agreement.

9.5 Binding Agreement; No Assignment . This Agreement shall be binding upon, and shall inure to the benefit of, the Parties and their respective legal representatives, successors and assigns. Company may assign this Agreement upon prior written notice to Practice. Practice may not assign this Agreement nor any rights hereunder, nor may it delegate any of the duties to be performed hereunder without the prior written consent of Company; provided , however, that notwithstanding the foregoing sentence to the contrary, Practice shall have the right to assign this Agreement to another corporate affiliate of Company upon written notice and shall have the right to subcontract with any other responsible parties, including specifically, corporate affiliates of Practice, for the performance of various aspects of its obligations hereunder, provided that Practice shall remain fully responsible for the performance of any such subcontractors.

9.6 Severability . Except as otherwise provided in Section 8.3 , in the event any provision of this Agreement is rendered invalid or unenforceable by the enactment of any applicable statute or ordinance or by any regulation duly promulgated or is made or declared unenforceable by any court of competent jurisdiction, the remainder of this Agreement shall remain in full force and effect.

9.7 Attorneys’ Fees . In the event any attorney is employed by any Party with regard to any legal action, arbitration or other proceeding brought by any Party for the enforcement of this Agreement, or because of an alleged dispute, breach, default or misrepresentation in connection with any of the provisions of this Agreement, then the prevailing Party, whether at trial or upon appeal, and in addition to any other relief to which the prevailing Party may be

 

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granted, shall be entitled to recover from the losing Party all costs, expenses and attorneys’ fees incurred by the prevailing Party in bringing or defending such action, arbitration or proceeding, and in enforcing any judgment granted therein, all of which costs, expenses and attorneys’ fees shall be deemed to have accrued upon the commencement of such action and shall be paid whether or not such action is prosecuted to judgment. Any judgment or order entered in such matter shall contain a specific provision providing for the recovery by the prevailing Party of attorneys’ fees, costs and expenses incurred in enforcing such judgment. For purposes of this Section 9.7 , attorneys’ fees shall include, without limitation, fees incurred in the following: post-judgment motions; contempt proceedings; garnishment, levy and debtor and third party examinations; discovery; and bankruptcy litigation.

9.8 Notices . All notices, requests, demands or other communications under this Agreement shall be in writing and shall be deemed to have been duly given on the date of service if served personally on the Party to whom notice is to be given, or on the third day after mailing if mailed to the Party to whom notice is to be given, by a recognized overnight carrier service, or by first class mail, registered or certified, postage prepaid, and properly addressed as follows:

 

TO PRACTICE:    Palm Beach Professional Group, Professional Corporation
   4400 N. Congress Avenue, Suite     
   West Palm Beach, Florida 33407
   Attn: Mark A. Calarco, D.O.
TO COMPANY:    Singer Island Recovery Center LLC
   4460 Medical Center Way
   West Palm Beach, Florida 33407
   Attn.: Chief Executive Officer
WITH COPY TO:   
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Candance A. Henderson-Grice, Chief Operating Officer
   Email: chenderson-grice@contactaac.com
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Kathryn Sevier Phillips, General Counsel and Secretary
   Fax: (615) 691-7130
   Email: ksphillips@contactaac.com

Each Party may change its address indicated above by giving the other Party written notice of the new address in the manner set forth above.

9.9 Governing Law . This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State. All actions, suits, or other proceedings with

 

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respect to this Agreement shall be brought only in a court of competent jurisdiction in the State. In any such action, suit, or proceeding, such court shall have personal jurisdiction over all of the parties hereto, and service of process upon them under any applicable statutes, laws, and rules shall be deemed valid and good.

9.10 Third Party Rights . This Agreement is entered into by and between the Parties hereto for their sole benefit. There is no intent by either Party to create or establish third party beneficiary status or rights in any third party to this Agreement and no third party shall have any right to enforce any right or enjoy any benefit created or established by this Agreement.

9.11 No Discrimination . No person shall be excluded from participation in, or be denied benefits of, or be otherwise subjected to discrimination in the performance of this Agreement or any Addenda on the grounds of disability, age, race, color, religion, sex, national origin or any other classification protected by federal and/or Tennessee constitutional, statutory and/or regulatory provisions.

9.12 Signatory . Each Party warrants that the person indicated on signatory line to this Agreement has all authority necessary to bind the Party and is the appropriate designated person to sign this Agreement.

9.13 Counterparts . This Agreement may be signed in multiple counterparts, each of which shall be deemed to be an original and all of which taken together shall constitute a single instrument.

9.14 Drafted Jointly . In the event of an ambiguity or question of intent or interpretation arises, this Agreement shall be construed as if drafted jointly by the Parties, and no presumption or burden of proof shall arise favoring or disfavoring any Party by virtue of authorship of the provisions of this Agreement.

9.15 Cooperation . The Parties agree to cooperate with each other to resolve promptly any outstanding financial, administrative or patient care issues upon the termination of this Agreement. Such obligation shall include, without limitation, the provision of patient, resident and/or administrative records, payments or other actions necessary to conclude the relationship of the Parties. This Section 9.15 shall survive the termination of this Agreement for any reason. Each Party further agrees to cooperate with the other to carry out the purpose and intent of this Agreement, including without limitation the execution and delivery to the appropriate Party of any further agreements and other documents and the taking of any action as may reasonably be required to effectuate the provisions of this Agreement.

[Signature Page Follows]

 

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IN WITNESS WHEREOF , the Parties hereto have duly executed this Agreement on the dates set forth below, provided that this Agreement is effective as of the Effective Date.

 

For Company:     For Practice:
Singer Island Recovery Center LLC     Palm Beach Professional Group,
    Professional Corporation
By:  

/s/ Michael T. Cartwright

    By:  

/s/ Mark A. Calarco, D.O.

Name:   Michael T. Cartwright     Name:   Mark A. Calarco, D.O.
Title:   Manager     Title:   President, Secretary and Treasurer

 

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Schedule 2.1

Practice’s Services

Professional Services

During the term of this Agreement, Practice, through its physician shareholder, employees and independent contractors (the “ Medical Providers ”), shall provide professional medical services to the patients of Company (the “ Patients ”). Medical Providers may include doctors of medicine, doctors of osteopathy and mid-level providers including physician assistants and advanced practice nurses. Practice shall effectively provide all the professional medical services as required by Company for the needs of its Patients. Such professional medical services shall include those service obligations set forth herein and other related services reasonably requested by Company.

Medical Director Services

During the term of this Agreement, in addition to the professional services described above, Practice shall, unless otherwise agreed to by the parties, provide a physician who is acceptable to Company, to serve as medical director of Facility (the “ Medical Director ”) and provide medical management and oversight for matters specific to Facility pursuant to a medical director agreement between Practice and Medical Director reasonably acceptable to Company (the “ Medical Director Agreement ”). Practice shall cause Medical Director to furnish those services as set forth in the Medical Director Agreement, in accordance with the terms thereof. Upon request, Practice shall provide Company with documentation reasonably acceptable to Company supporting Medical Director’s fulfillment of such duties with Company also retaining the right to conduct such audits thereof as Company determines reasonably necessary to support Company’s payment for such services under this Agreement.

Practice shall provide support, assistance, and work cooperatively with Medical Director who will provide medical management and oversight for Facility. Practice, at the request of Company, shall immediately remove a Medical Director from Facility for cause, as “cause” is defined in Section 2.3.8 hereof.

The term “Medical Provider” as used in this Agreement shall include the Medical Director, provided that any provision that relates specifically to professional medical services will not apply to the Medical Director to the extent that the Medical Director is providing only administrative and not professional services.


Schedule 3.1

Compensation

Practice acknowledges that Practice may sometimes bill separately for the services of Medical Providers, and at other times Company submits global bills for the services of both the Facility and the Medical Providers. In light of the foregoing, Company shall pay to Practice the fees set forth below for services provided by the Medical Providers at the Facility to the extent that such provider services are not separately billed by Practice. To the extent Practice bills separately for Medical Provider services, Company shall not be obligated to pay a fee for such services.

 

Provider

   Fee

Physician/Psychologist Clinical Services

   $125 - $175 per hour*

Medical Director Services

   $100 - $150 per hour*

Mid-level Provider Services (PA or NP)

   $55 - $95 per hour*

 

* Specific hourly rate within the noted range shall be determined by Company in its reasonable discretion after consultation with Practice, based on the experience level, specialty, certifications, and other qualifications of the applicable practitioner.

If Practice is asked by Company to provide additional practitioner services at the Facility, Company shall pay to Practice a fee for such services equal to the rate that Practice pays such provider for the services (unless the service is separately billable by Practice). Practice represents and warrants that the compensation it pays to Medical Providers, and the corresponding fees paid by Company, shall be reasonable and consistent with fair market value. Compensation shall be paid pursuant to Company’s standard payment policies and timing.


Schedule 7.2

HIPAA Business Associate Addendum

This HIPAA Business Associate Addendum (“ Addendum ”) amends and is made part of that certain Professional Services Agreement for Medical Staffing (“ Service Agreement ”), by and between Singer Island Recovery Center LLC (“ Entity ”) and Palm Beach Professional Group, Professional Corporation (“ Associate ”) to the extent that Associate is acting as a Business Associate of Entity.

Entity and Associate agree that the parties incorporate this Addendum into the Service Agreement in order to comply with the requirements of: the Health Insurance Portability and Accountability Act of 1996 (“ HIPAA ”), the Health Information Technology for Economic and Clinical Health Act (“ HITECH ”) and their implementing regulations set forth at 45 C.F.R. Parts 160 and Part 164 (the “ HIPAA Rules ”); and Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2 (“ Part 2 Regulations ”). To the extent Associate is acting as a Business Associate of Entity pursuant to the Service Agreement, the provisions of this Addendum shall apply, and Associate shall be subject to the penalty provisions of HIPAA as specified in 45 C.F.R. Part 160.

1. Definitions . Capitalized terms not otherwise defined in this Addendum shall have the meaning set forth in the HIPAA Rules. References to “PHI” mean Protected Health Information maintained, created, received or transmitted by Associate from Entity or on Entity’s behalf.

2. Uses or Disclosures . Associate will neither use nor disclose PHI except as permitted or required by this Addendum or as Required By Law. To the extent Associate is to carry out an obligation of Entity under the HIPAA Rules, Associate shall comply with the requirements of the HIPAA Rules that apply to Entity in the performance of such obligation. Without limiting the foregoing, Associate will not sell PHI or use or disclose PHI for purposes of marketing or fundraising, as defined and proscribed in the HIPAA Rules. Associate is permitted to use and disclose PHI:

(a) to perform any and all obligations of Associate as described in the Service Agreement, provided that such use or disclosure is consistent with the terms of Entity’s notice of privacy practices and would not violate the HIPAA Rules or the Part 2 Regulations, if done by Entity directly;

(b) to perform Data Aggregation services relating to the health care operations of Entity, provided that such services are part of Associate’s obligations as set forth in the Service Agreement;

(c) to create de-identified information in accordance with 45 C.F.R. § 164.514(b), provided that such de-identified information may be used and disclosed only consistent with applicable law; and

(d) as necessary for Associate’s proper management and administration and to carry out Associate’s legal responsibilities (collectively “ Associate’s Operations ”) provided that: any


disclosure made for purposes of Associate’s Operations is Required By Law or is made after Associate obtains reasonable assurances, evidenced by a written contract, from the recipient that the recipient: (i) will hold such PHI in confidence and use or further disclose it only for the purpose for which Associate disclosed it to the recipient or as Required By Law; (ii) will notify Associate of any instance of which the recipient becomes aware in which the confidentiality of such PHI was breached; (iii) acknowledges in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations; and (iv) agrees to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations. Associate shall promptly notify Entity of any disclosures made for purposes of Associate’s Operations.

In the event Entity notifies Associate of a restriction request that would restrict a use or disclosure otherwise permitted by this Addendum, Associate shall comply with the terms of the restriction request.

3. Safeguards . Associate will use appropriate administrative, technical and physical safeguards to prevent the use or disclosure of PHI other than as permitted by this Addendum and shall maintain policies and procedures to detect, prevent, and mitigate identity theft based on PHI or information derived from PHI. Associate will also comply with the provisions of 45 C.F.R. Part 164, Subpart C of the HIPAA Rules with respect to electronic PHI to prevent any use or disclosure of such information other than as provided by this Addendum, which obligation shall include maintaining safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI.

4. Policies and Training . Associate has policies in place regarding the confidential and secure treatment of PHI in accordance with HIPAA and the Part 2 Regulations. Associate shall require its employees to adhere to such policies and shall train its employees regarding the requirements of this Addendum and applicable confidentiality and security laws and regulations.

5. Subcontractors . In accordance with 45 C.F.R. § 164.308(b)(2) and 164.502(e)(1)(ii), Associate will ensure that all of its subcontractors that create, receive, maintain or transmit PHI on behalf of Associate agree by written contract to comply with the same restrictions and conditions that apply to Associate with respect to such PHI, including but not limited to (i) the obligation to safeguard PHI and comply with 45 C.F.R. Part 164, Subpart C; and (ii) acknowledging in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations, and must agree to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations.

6. Minimum Necessary . Associate represents that the PHI requested, used or disclosed by Associate shall be the minimum amount necessary to carry out the purposes of the Service Agreement. Associate will limit its uses and disclosures of, and requests for, PHI to the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request.

7. Obligations of Entity . Entity shall notify Associate of (i) any limitations in its notice of privacy practices, (ii) any changes in, or revocation of, permission by an individual to use or disclose PHI, and (iii) any confidential communication request or restriction on the use or disclosure of PHI that Entity has agreed to or with which Entity is required to comply, to the extent any of the foregoing affect Associate’s use or disclosure of PHI to perform its obligations as described in the Service Agreement.


8. Access and Amendment . In accordance with 45 C.F.R. § 164.524, Associate will permit Entity or, at Entity’s request, an individual (or the individual’s designee) to inspect and obtain copies of any PHI about the individual that is in Associate’s custody or control and that is maintained in a Designated Record Set. If the requested PHI is maintained electronically, Associate must provide a copy of the PHI in the electronic form and format requested by the individual, if it is readily producible, or, if not, in a readable electronic form and format as agreed to by Entity and the individual. Associate will notify Entity of any request (including but not limited to subpoenas) that Associate receives for access to PHI that is in Associate’s custody or control within five (5) business days of receipt of such request. Entity shall be responsible for making determinations about access. Associate will, upon receipt of notice from Entity, promptly amend or permit Entity access to amend any portion of the PHI that is in Associate’s custody or control so that Entity may meet its amendment obligations under 45 C.F.R. § 164.526.

9. Disclosure Accounting . Except for disclosures excluded from the accounting obligation by the HIPAA Rules and regulations issued pursuant to HITECH, Associate will record for each disclosure that Associate makes of PHI the information necessary for Entity to make an accounting of disclosures pursuant to the HIPAA Rules. In the event the U.S. Department of Health and Human Services (“ HHS ”) finalizes regulations requiring Covered Entities to provide access reports, Associate shall also record such information with respect to electronic PHI held by Associate as would be required under the regulations for Covered Entities beginning on the effective date applicable to Entity. Associate will make information required by this Section 9 available to Entity promptly upon Entity’s request for the period requested, but for no longer than the six (6) years preceding Entity’s request for the information or such other period required by the HIPAA Rules (except Associate need not have any information for disclosures occurring before the effective date of any previous HIPAA business associate agreements between the parties or, if none, the effective date of this Addendum).

10. Inspection of Books and Records . Associate will make its internal practices, books, and records, relating to its use and disclosure of PHI available upon request to Entity or HHS to determine Entity’s compliance with the HIPAA Rules.

11. Reporting . To the extent Associate becomes aware or discovers any use or disclosure of PHI not permitted by this Addendum, any Security Incident involving electronic PHI, any Breach of Unsecured Protected Health Information or any Red Flag (as defined at 16 C.F.R. § 681.2(b)) related to any individual who is the subject of PHI, Associate shall promptly report such use, disclosure, Security Incident, Breach or Red Flag to Entity. Associate shall mitigate, to the extent practicable, any harmful effect known to it of a Security Incident, Breach or use or disclosure of PHI by Associate not permitted by this Addendum. Notwithstanding the foregoing, the parties acknowledge and agree that this Section 11 constitutes notice by Associate to Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents (as defined below) for which no additional notice to Entity shall be required. “Unsuccessful Security Incidents” shall include, but not be limited to, pings and other broadcast attacks on Associate’s firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or


disclosure of electronic PHI. All reports of Breaches shall be made within ten (10) business days of Associate discovering the Breach and shall comply with and include the information specified at 45 C.F.R. § 164.410. Associate shall promptly reimburse Entity all reasonable costs incurred by Entity with respect to providing notification of and mitigating a Breach involving Associate, including but not limited to printing, postage costs and toll-free hotline costs.

12. Confidentiality of Alcohol and Drug Abuse Patient Records . Associate: (1) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from Entity about individuals who are patients of Entity (“ Patients ”), it is fully bound by the provisions of the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2; and (2) undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to Patients otherwise than as expressly provided for in the Part 2 Regulations.

13. Term and Termination . This Addendum shall be effective as of the effective date of the Service Agreement and shall remain in effect until termination of the Service Agreement. Either party may terminate this Addendum and the Service Agreement effective immediately if it determines that the other party has breached a material provision of this Addendum and failed to cure such breach within thirty (30) days of being notified by the other party of the breach. If the non-breaching party determines that cure is not possible, such party may terminate this Addendum and the Service Agreement effective immediately upon written notice to other party.

Upon termination of this Addendum for any reason, Associate will, if feasible, return to Entity or securely destroy all PHI maintained by Associate in any form or medium, including all copies of such PHI, at no cost to Entity. Further, Associate shall recover any PHI in the possession of its agents and subcontractors and return to Entity or securely destroy all such PHI. Notwithstanding the foregoing, Associate shall notify Entity and receive Entity’s written consent prior to destroying any PHI of which Entity does not maintain a duplicate copy. In the event that Associate determines that returning or destroying any PHI is infeasible, Associate shall promptly notify Entity of the conditions that make return or destruction infeasible. With regard to any PHI that Entity agrees cannot feasibly be returned to Entity or destroyed, Associate may maintain such PHI but shall continue to abide by the terms and conditions of this Addendum with respect to such PHI and shall limit its further use or disclosure of such PHI to those purposes that make return or destruction of the PHI infeasible. Associate shall comply with this Section 13 within thirty (30) days of termination of this Addendum. Associate shall provide Entity with written certification of its compliance with this Section 13 within forty-five (45) days of termination of this Addendum. Upon termination of this Addendum for any reason, all of Associate’s obligations under this Addendum shall survive termination and remain in effect (a) until Associate has completed the return or destruction of PHI as required by this Section 13 and (b) to the extent Associate retains any PHI pursuant to this Section 13 .

14. General Provisions . In the event that any final regulation or amendment to final regulations is promulgated by HHS or other government regulatory authority with respect to PHI, this Addendum will automatically be amended to remain in compliance with such regulations, and Associate shall promptly amend its contracts, if any, with subcontractors and agents to conform to the terms of this Addendum. Any ambiguity in this Addendum shall be resolved to permit Entity to comply with the HIPAA Rules and the Part 2 Regulations. Nothing


in this Addendum shall be construed to create any rights or remedies in any third parties or any agency relationship between the parties. A reference in this Addendum to a section in the HIPAA Rules or the Part 2 Regulations means the section as in effect or as amended. This Addendum replaces and supersedes and previous business associate agreements between the parties. The terms and conditions of this Addendum override and control any conflicting term or condition of the Service Agreement. To the extent Associate has limited its liability under the terms of the Service Agreement by a maximum recovery for direct damages, disclaimer against any consequential, indirect or punitive damages or any other limitation, all limitations shall exclude any damages to Entity arising from Associate’s breach of its obligations under this Addendum. All non-conflicting terms and conditions of the Service Agreement remain in full force and effect.

Exhibit 10.42

PROFESSIONAL SERVICES AGREEMENT

For Medical Staffing

THIS PROFESSIONAL SERVICES AGREEMENT for Medical Staffing (“ Agreement ”) is made this 5 th day of August, 2014 (the “ Effective Date ”), between Palm Beach Professional Group, Professional Corporation (“ Practice ), a professional corporation organized under the laws of Florida, and Singer Island Recovery Center LLC d/b/a The Academy, a Florida limited liability company (“ Company ”) (individually, a “ Party ,” and, collectively, the “ Parties ”).

W I TN E S S E T H:

WHEREAS , Company has established and operates an addiction treatment facility, Singer Island Recovery Center LLC d/b/a The Academy (“ Facility ”), located at 4400 N. Congress Avenue, Suite 100, West Palm Beach, Florida 33407;

WHEREAS , Practice employs Medical Providers and other medical personnel specializing in the treatment of various addictions;

WHEREAS , Practice is owned by a physician licensed to practice medicine in the state of Florida (the “ State ”); and

WHEREAS , Company desires to engage Practice as of the Effective Date to provide, or arrange the provision of, medical services on behalf of Company, and Practice desires to accept such engagement as of the Effective Date, all upon the terms and conditions set forth in this Agreement.

NOW , THEREFORE , for and in consideration of the mutual agreements, covenants, terms and conditions herein contained, the Parties agree as follows:

ARTICLE I

ESTABLISHMENT OF PROFESSIONAL RELATIONSHIP

1.1 Engagement of Practice . As of the Effective Date, Company engages Practice, and Practice accepts said engagement, to provide medical services in accordance with the terms and conditions of this Agreement.

1.2 Relationship of the Parties . In the performance of their respective duties and obligations hereunder, the Parties are independent contractors, and as such they shall remain professionally and economically independent of each other. The Parties are not, and shall not be deemed to be, joint venturers, partners, employees, or agents of each other (except with respect to an agency for billing and collection activities expressly addressed in this Agreement). Neither Party shall have any authority to bind or incur any financial obligations on behalf of the other without the other’s express written consent, and then only insofar as such authority is conferred by such express written consent.


ARTICLE II

PRACTICE’S OBLIGATIONS

2.1 General Obligations . Practice shall provide the Medical Provider services set forth on Schedule 2.1 , attached hereto and incorporated herein by reference.

2.2 Responsibility for Medical Provider Services . Practice shall control and be responsible for the provision of medical services to Patients (as such term is defined on S chedule 2.1 ), and Company shall not engage in the practice of medicine nor shall it intervene or interfere in professional medical judgment of Practice or any Medical Provider; provided , however, that Practice shall cause the Medical Providers to comply with Company’s systems and procedures for review and improvement of the delivery of care.

2.3 Qualifications and Standards . Practice shall take all necessary actions to ensure that each Medical Provider satisfies the following conditions at all times during the Term:

2.3.1 Licensure and Experience Levels . Each Medical Provider shall maintain an unrestricted license to practice his or her specialty in the State and at all times shall be in good standing with the appropriate licensing board. Each Medical Provider shall have a level of competence, experience and skill at least comparable to that prevailing in the community.

2.3.2 Federal DEA Number . The Medical Providers shall maintain a Federal DEA number without restrictions, to the extent necessary for his or her practice.

2.3.3 Medical Standards . Each Medical Provider shall perform all medical services to be provided hereunder in accordance with the current standards of care in the medical community and any credentialing and quality criteria that are adopted from time to time by Company, the Facility and/or Practice

2.3.4 Continuing Education . Medical Providers shall participate in such continuing medical education and training programs as required by law to maintain skills compatible with standards of medical care in the community.

2.3.5 Bylaws . Medical Providers shall comply with any bylaws, policies, rules or regulations of Facility or Company, as may be amended from time to time.

2.3.6 Laws . Medical Providers shall comply with all applicable standards, rulings, regulations and requirements of the United States Department of Health and Human Services, the State’s department of health, the applicable accreditation agency of the Facility, and any federal, state or local government agency, third party payor or accrediting body having jurisdiction over or providing reimbursement for the Facility and any programs and services offered by either the Facility or Company.

2.3.7 Cooperation . Practice shall promptly notify Company if a claim of malpractice or professional discipline is asserted against any Medical Provider resulting from medical services provided at Facility; additionally Practice shall notify Company of claims not yet asserted against Medical Providers, but the potential for which Practice is aware.

 

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2.3.8 Approval and Removal . Each Medical Provider shall be subject to the initial approval of Company before he or she commences providing services at Facility. In addition, Practice, at the request of Company, shall immediately remove a Medical Provider from Facility for cause. For purposes of this Section 2.3.8 , “for cause” shall be determined by Company acting reasonably and in good faith and shall include the following: (a) suspension or revocation or other sanction of his or her medical license, specialty board certification, or Federal Drug Enforcement Agency (“ DEA ”) registration; (b) suspension, revocation, or reduction of his or her status or privileges as a member of the medical staff of any hospital utilized by Company for Patients served by the Medical Providers (including without limitation any resignation of membership or privileges in lieu of or to avoid any of the foregoing actions); (c) being arrested or indicted for, or convicted of any felony or any criminal charge relating to the practice of medicine; (d) being found by the appropriate licensure board or other state or federal regulatory agency to have violated any provision of law or the applicable code of medical ethics; (e) cancellation, termination or non-renewal of his or her professional liability insurance and failure to obtain replacement coverage within thirty (30) days; or (f) having committed any actions or inactions which pose an immediate and significant threat to Patients.

2.4 Compensation Responsibility . Practice shall be solely responsible for establishing and paying the compensation and fringe benefits, if any, to the Medical Providers. Practice shall be solely responsible for the payment and withholding of appropriate amounts for income tax, social security, unemployment insurance, and state disability insurance taxes. Practice shall also maintain in full force and effect all worker’s compensation insurance as may be required under the worker’s compensation laws of the State.

2.5 Medical Provider Staffing Levels . As of the Effective Date, Practice shall assign to Facility Medical Providers necessary to satisfy the patient needs at the Facility.

2.6 Authority . Practice has the right to enter into this Agreement, and neither the execution of this Agreement nor Practice’s performance hereunder will result in it being in breach or default of any existing agreement.

ARTICLE III

COMPENSATION

3.1 General Compensation Principles . Practice shall be compensated for the services provided hereunder pursuant to the terms of this Agreement as described in Schedule 3.1 , which is attached hereto and incorporated herein by reference. The Parties hereby acknowledge and agree that such amount represents the fair market value of the services provided hereunder.

ARTICLE IV

PATIENT CHARGES, BILLING AND COLLECTION

4.1 Billing; Assignment of Fees . Company, directly or through an affiliate, shall bill payors and patients for all technical and facility fees of the Facility. In addition, to the extent permissible by applicable law and third party payor policies, Company may (directly or through

 

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an affiliate) bill payors and patients globally for Company’s services and also the professional services of Practice and the Medical Providers that are provided pursuant to this Agreement. Practice authorizes Company, directly or through an affiliate, to bill and collect all professional fees of Practice and the Medical Providers, as Practice’s and the Medical Providers’ agent and attorney-in-fact to the extent permitted by applicable law for all services rendered by Practice or the Medical Providers at the Facility or on behalf of Company hereunder, either in Company’s own name or in Practice’s or individual Medical Provider’s name and provider number. Practice shall ensure that each Medical Provider executes such documentation as may be necessary to permit such billing by Company. To the extent that it is not allowable by law or payor policies for Company to bill for services on behalf of Practice or Medical Providers, Practice will bill in its own name for such services, provided that Practice intends to engage American Addiction Centers, Inc., an affiliate of Company, to provide billing support services. Practice shall ensure that duplicative billing does not occur, and neither it nor any Medical Provider will payors or patients for the same services that are billed by Company.

4.2 Practice to Provide Billing Information . For all applicable services described in Section 4.1 above and in accordance with applicable law, Practice shall provide Company with all billing information for services rendered by the Medical Providers, including, but not limited to, the name of the Patient, the date of service, the nature and extent of services provided, Patient diagnosis, and any supporting medical and non-medical information necessary to bill such services and to obtain payment and/or reimbursement. Each Medical Provider shall provide the above-described billing information to Company within seven (7) calendar days after the applicable medical services are rendered. The applicable treating Medical Provider shall be responsible for appropriately coding the service provided and supplying the correct CPT, KEY, ICD-9 (or ICD-10 once applicable) or other codes associated with the service.

ARTICLE V

INSURANCE

5.1 Comprehensive General Liability and Property Insurance . Company shall procure and maintain during the Term of this Agreement comprehensive general liability insurance covering its activities relating to Facility and property insurance covering the Facility. The comprehensive general liability insurance maintained hereunder shall be in amounts deemed sufficient by Company to protect against risks and losses associated with the operations of Facility.

5.2 Company’s Professional Liability Insurance . Company shall procure and maintain in full force and effect during the Term of this Agreement professional liability insurance covering Company and appropriate personnel provided by Company pursuant to this Agreement, including, without limitation, Company’s provider employees and contractors (subject to prior approval of insurer), against errors and omissions arising from Patient services and/or non-medical services rendered by Company pursuant to this Agreement. All premiums, costs and expenses associated with such professional liability insurance shall be borne by and paid by Company. The professional liability insurance procured by Company shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate. For purposes of Sections 5.1 and 5.2 , the term “insurance” shall include self-insurance arrangements maintained by Company for itself and its corporate affiliates, including Facility.

 

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5.3 Practice’s Professional Liability Insurance . Practice shall procure and maintain in full force and effect during the Term of this Agreement, and for a period of three (3) years subsequent to the expiration or earlier termination of this Agreement, professional liability insurance (i.e., medical malpractice insurance) with an insurer acceptable to Company, protecting Practice and its shareholders, officers, directors, and the Medical Providers against errors and omissions arising from professional services and/or medical services rendered by Practice and the Medical Providers. Such policy of insurance shall name Company as an additional insured. The insurance required by this Section 5.3 shall specifically extend to acts or omissions of Medical Providers occurring both prior and subsequent to the Effective Date. All premiums, costs and expenses associated with such professional liability insurance shall be borne by Practice. The professional liability insurance required by this Section 5.3 shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate.

5.4 Proof of Insurance . At the request of the other Party, each Party shall furnish copies of or Certificates of Insurance on all policies required under this Article V (or evidence of self-insurance) as evidence of the insurance coverage to be procured pursuant to this Agreement. In the case of Company, this evidence shall also specifically include evidence of “tail” or other coverage for acts and omissions occurring prior to the Effective Date. The insurance coverage required under this Agreement shall not be canceled, modified, reduced or otherwise materially changed, except upon thirty (30) days’ prior written notice to the non-procuring Party.

ARTICLE VI

INDEMNIFICATION

6.1 Indemnification by Company . Company shall indemnify, defend and hold Practice, and the shareholders, directors, officers and employees of Practice, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs, and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly from any negligent or willful act or omission of Company or its non-Medical Provider employees providing services at Facility. Notwithstanding any provisions of the preceding sentence to the contrary, Company shall not be liable to Practice for any consequential, exemplary or punitive damages. The duty of Company to indemnify, defend and hold harmless Practice shall only apply to the extent that any such loss sustained by Practice is not covered by insurance. The indemnification provisions of this Section 6.1 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other.

6.2 Indemnification by Practice . Practice shall indemnify, defend and hold Company, and the shareholders, directors, officers and employees of Company, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly, from any negligent or willful act or omission of any Medical Provider, including, specifically, (i) negligent or willful acts occurring both prior to and subsequent to the Effective Date and (ii)

 

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claims against Company attributable directly or indirectly to incorrect billing information provided to Company by Practice or any Medical Provider. Notwithstanding any provisions of the preceding sentence to the contrary, Practice shall not be liable to Company for any consequential, exemplary or punitive damages. The indemnification provisions of this Section 6.2 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other. A provision similar to that set forth in this Section 6.2 shall be contained in each contract between Practice and any independent contractor providing professional medical services for Practice at the Facility in order to ensure that each such Medical Provider has agreed to indemnify Company as required by this Section 6.2 .

ARTICLE VII

RECORDS AND CONFIDENTIALITY

7.1 Ownership of Records and Files . All business or medical records and files of whatever nature or kind, including Patients’ files and x-rays, are the property of Company to the extent permitted by law; neither Practice nor individual Medical Providers shall acquire any proprietary rights with respect to such records. However, at Practice’s written request, Company shall provide Medical Providers with copies of any records reflecting services performed by such Medical Provider with respect to (a) any claims against him/her in the nature of malpractice, (b) any charges against him/her issued by a licensing board or professional association or (c) for any other purpose deemed appropriate by Company

7.2 Confidentiality of Medical Records . Both Parties shall comply with all applicable federal and state laws and regulations regarding the confidential and secure treatment of individually identifiable health information, including 42 C.F.R. Part 2, and with the terms of the Business Associate Addendum attached as Schedule 7.2 hereto and incorporated herein by reference.

7.3 Medical Records upon Termination . Upon the expiration or earlier termination of this Agreement, unless a Patient specifies otherwise and in accordance with applicable law, Company shall be entitled to the original medical records for all Patients, and Practice shall be entitled to copy such records, with the cost of any copies to be home by Practice. For such period as is required by applicable statutes, Company shall keep possession of the original medical records and shall retain the records in their original condition, shall store the records in a safe place and make the records available to Practice without charge if reasonably necessary for any purpose, including, without limitation, Patient care and medical malpractice defense.

ARTICLE VIII

TERM AND TERMINATION

8.1 Term . This Agreement shall be effective for a term of five (5) years, beginning on the Effective Date, unless terminated pursuant to the provisions of this Article VIII (the “ Initial Term ”). Upon expiration of the Initial Term, this Agreement will automatically renew for additional one (1) year terms (the “ Renewal Terms ”) unless either Party shall provide notice to the other Party of its intent to terminate the Agreement under the terms of this Section 8.1 (“ Notice of Intent to Terminate ”). Notice of Intent to Terminate must be provided no later than one (1) year prior to the expiration of the Initial Term, and no later than ninety (90) days prior to the expiration of any Renewal Term.

 

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8.2 Termination upon Insolvency . If either Party shall apply for or consent to the appointment of a receiver, trustee or liquidation of itself, or if all or a substantial part of its assets, file a voluntary petition in bankruptcy or admit in writing its inability to pay its debts as they become due, make a general assignment for the benefit of creditors, file a petition or an answer seeking reorganization or arrangement with creditors, or take advantage of any insolvency law, or if an order, judgment, or decree shall be entered by a court of competent jurisdiction or an application of a creditor, adjudicating such party to be bankrupt or insolvent, or approving a petition seeking reorganization of such Party or appointing a receiver, trustee or liquidator of such Party or of all or a substantial part of its assets, and such order, judgment, or decree shall continue in effect and unstayed for a period of thirty (30) consecutive days, then the other Party may terminate this Agreement upon ten (10) days prior written notice to such Party.

8.3 Termination upon Legal Prohibitions of Relationship . If counsel jointly selected by the Parties should determine (the “ Determination ”) that it is more likely than not that applicable legislation, regulations, rules or procedures (collectively referred to herein as a “ Law ”) in effect or to become effective as of a date certain, or if Practice or Company receives notice (the “ Notice ”) of an actual or threatened decision, finding or action by any governmental or private agency or court (collectively referred to herein as an “ Action ”), which Law or Action, if or when implemented, would have the effect of subjecting either Party to civil or criminal prosecution under state and/or federal Laws, or other adverse proceeding on the basis of their participation herein, then the Parties shall attempt in good faith to amend this Agreement to the extent necessary in order to comply with such Law or to avoid the Action, as applicable. If, within ninety (90) days of providing written notice of such Determination or Notice to the other Party, the Parties acting in good faith are unable to mutually agree upon and make amendments or alterations to this Agreement to meet the requirements in question, or alternatively, the Parties mutually determine in good faith that compliance with such requirements is impossible or unfeasible, then this Agreement shall be terminated without penalty, charge or continuing liability upon the earlier of the following: the date one hundred eighty (180) days subsequent to the date upon which either Party gives written notice to the other Party or the effective date on which the Law or Action prohibits the relationship of the Parties pursuant to this Agreement.

8.4 Termination upon Breach . Either Party may elect to terminate this Agreement in the event that the other Party is in material breach of this Agreement and such default continues for a period of fifteen (15) calendar days after written notice thereof has been given to the Party in default by the other Party; provided , however, that Company may immediately terminate this Agreement if Practice fails to provide, or arrange the provision of, adequate professional medical services pursuant to this Agreement for a period of three (3) calendar days.

8.5 Termination Without Cause . This Agreement shall automatically terminate upon one hundred and eighty (180) days’ notice by either Party to the other Party.

8.6 Termination and Liabilities . In the event either Party validly elects to terminate this Agreement pursuant to the provisions of this Article VIII or the Agreement expires by its own terms, the liabilities and obligations of the Parties shall cease as of the date of termination,

 

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except that each Party shall be responsible for: (a) any payments or other obligations arising or accruing prior to the termination date and (b) any breach arising after termination or expiration with respect to obligations that continue after such expiration or termination. Neither Party shall be liable to the other for any damages resulting from any event of force majeure. The Parties agree that upon such termination, they will mutually work to assure an orderly transition of services.

ARTICLE IX

GENERAL PROVISIONS

9.1 Independence of Medical Judgment . Nothing in this Agreement shall affect the exercise of Medical Providers’ independent medical judgment.

9.2 Entire Agreement; Amendment . This Agreement constitutes the entire agreement between the Parties pertaining to the subject matter contained herein and supersedes all prior and contemporaneous agreements, representations and understandings of the Parties which relate to the subject matter of this Agreement. No supplement, amendment or modification of this Agreement shall be binding unless executed in writing by the Parties, unless otherwise provided herein.

9.3 No Waiver . No waiver of any of the provisions of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the Party making the waiver.

9.4 Subject Headings . The subject headings of the Articles and Sections of this Agreement are included for purposes of convenience only, and shall not affect the construction or interpretation of any of the provisions of this Agreement.

9.5 Binding Agreement; No Assignment . This Agreement shall be binding upon, and shall inure to the benefit of, the Parties and their respective legal representatives, successors and assigns. Company may assign this Agreement upon prior written notice to Practice. Practice may not assign this Agreement nor any rights hereunder, nor may it delegate any of the duties to be performed hereunder without the prior written consent of Company; provided , however, that notwithstanding the foregoing sentence to the contrary, Practice shall have the right to assign this Agreement to another corporate affiliate of Company upon written notice and shall have the right to subcontract with any other responsible parties, including specifically, corporate affiliates of Practice, for the performance of various aspects of its obligations hereunder, provided that Practice shall remain fully responsible for the performance of any such subcontractors.

9.6 Severability . Except as otherwise provided in Section 8.3 , in the event any provision of this Agreement is rendered invalid or unenforceable by the enactment of any applicable statute or ordinance or by any regulation duly promulgated or is made or declared unenforceable by any court of competent jurisdiction, the remainder of this Agreement shall remain in full force and effect.

9.7 Attorneys’ Fees . In the event any attorney is employed by any Party with regard to any legal action, arbitration or other proceeding brought by any Party for the enforcement of

 

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this Agreement, or because of an alleged dispute, breach, default or misrepresentation in connection with any of the provisions of this Agreement, then the prevailing Party, whether at trial or upon appeal, and in addition to any other relief to which the prevailing Party may be granted, shall be entitled to recover from the losing Party all costs, expenses and attorneys’ fees incurred by the prevailing Party in bringing or defending such action, arbitration or proceeding, and in enforcing any judgment granted therein, all of which costs, expenses and attorneys’ fees shall be deemed to have accrued upon the commencement of such action and shall be paid whether or not such action is prosecuted to judgment. Any judgment or order entered in such matter shall contain a specific provision providing for the recovery by the prevailing Party of attorneys’ fees, costs and expenses incurred in enforcing such judgment. For purposes of this Section 9.7 , attorneys’ fees shall include, without limitation, fees incurred in the following: post-judgment motions; contempt proceedings; garnishment, levy and debtor and third party examinations; discovery; and bankruptcy litigation.

9.8 Notices . All notices, requests, demands or other communications under this Agreement shall be in writing and shall be deemed to have been duly given on the date of service if served personally on the Party to whom notice is to be given, or on the third day after mailing if mailed to the Party to whom notice is to be given, by a recognized overnight carrier service, or by first class mail, registered or certified, postage prepaid, and properly addressed as follows:

 

TO PRACTICE:    Palm Beach Professional Group, Professional Corporation
   4400 N. Congress Avenue, Suite     
   West Palm Beach, Florida 33407
   Attn: Mark A. Calarco, D.O.
TO COMPANY:    Singer Island Recovery Center LLC d/b/a The Academy
   4400 N. Congress Avenue, Suite 100
   West Palm Beach, Florida 33407
   Attn.: Chief Executive Officer
WITH COPY TO:   
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Candance A. Henderson-Grice, Chief Operating Officer
   Email: chenderson-grice@contactaac.com
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Kathryn Sevier Phillips, General Counsel and Secretary
   Fax: (615) 691-7130
   Email: ksphillips@contactaac.com

Each Party may change its address indicated above by giving the other Party written notice of the new address in the manner set forth above.

 

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9.9 Governing Law . This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State. All actions, suits, or other proceedings with respect to this Agreement shall be brought only in a court of competent jurisdiction in the State. In any such action, suit, or proceeding, such court shall have personal jurisdiction over all of the parties hereto, and service of process upon them under any applicable statutes, laws, and rules shall be deemed valid and good.

9.10 Third Party Rights . This Agreement is entered into by and between the Parties hereto for their sole benefit. There is no intent by either Party to create or establish third party beneficiary status or rights in any third party to this Agreement and no third party shall have any right to enforce any right or enjoy any benefit created or established by this Agreement.

9.11 No Discrimination . No person shall be excluded from participation in, or be denied benefits of, or be otherwise subjected to discrimination in the performance of this Agreement or any Addenda on the grounds of disability, age, race, color, religion, sex, national origin or any other classification protected by federal and/or Tennessee constitutional, statutory and/or regulatory provisions.

9.12 Signatory . Each Party warrants that the person indicated on signatory line to this Agreement has all authority necessary to bind the Party and is the appropriate designated person to sign this Agreement.

9.13 Counterparts . This Agreement may be signed in multiple counterparts, each of which shall be deemed to be an original and all of which taken together shall constitute a single instrument.

9.14 Drafted Jointly . In the event of an ambiguity or question of intent or interpretation arises, this Agreement shall be construed as if drafted jointly by the Parties, and no presumption or burden of proof shall arise favoring or disfavoring any Party by virtue of authorship of the provisions of this Agreement.

9.15 Cooperation . The Parties agree to cooperate with each other to resolve promptly any outstanding financial, administrative or patient care issues upon the termination of this Agreement. Such obligation shall include, without limitation, the provision of patient, resident and/or administrative records, payments or other actions necessary to conclude the relationship of the Parties. This Section 9.15 shall survive the termination of this Agreement for any reason. Each Party further agrees to cooperate with the other to carry out the purpose and intent of this Agreement, including without limitation the execution and delivery to the appropriate Party of any further agreements and other documents and the taking of any action as may reasonably be required to effectuate the provisions of this Agreement.

[Signature Page Follows]

 

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IN WITNESS WHEREOF , the Parties hereto have duly executed this Agreement on the dates set forth below, provided that this Agreement is effective as of the Effective Date.

 

For Company:     For Practice:
Singer Island Recovery Center LLC     Palm Beach Professional Group,
d/b/a The Academy     Professional Corporation
By:  

/s/ Michael T. Cartwright

    By:  

/s/ Mark A. Calarco, D.O.

Name:   Michael T. Cartwright     Name:   Mark A. Calarco, D.O.
Title:   Manager     Title:   President, Secretary and Treasurer

 

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Schedule 2.1

Practice’s Services

Professional Services

During the term of this Agreement, Practice, through its physician shareholder, employees and independent contractors (the “ Medical Providers ”), shall provide professional medical services to the patients of Company (the “ Patients ”). Medical Providers may include doctors of medicine, doctors of osteopathy and mid-level providers including physician assistants and advanced practice nurses. Practice shall effectively provide all the professional medical services as required by Company for the needs of its Patients. Such professional medical services shall include those service obligations set forth herein and other related services reasonably requested by Company.

Medical Director Services

During the term of this Agreement, in addition to the professional services described above, Practice shall, unless otherwise agreed to by the parties, provide a physician who is acceptable to Company, to serve as medical director of Facility (the “ Medical Director ”) and provide medical management and oversight for matters specific to Facility pursuant to a medical director agreement between Practice and Medical Director reasonably acceptable to Company (the “ Medical Director Agreement ”). Practice shall cause Medical Director to furnish those services as set forth in the Medical Director Agreement, in accordance with the terms thereof. Upon request, Practice shall provide Company with documentation reasonably acceptable to Company supporting Medical Director’s fulfillment of such duties with Company also retaining the right to conduct such audits thereof as Company determines reasonably necessary to support Company’s payment for such services under this Agreement.

Practice shall provide support, assistance, and work cooperatively with Medical Director who will provide medical management and oversight for Facility. Practice, at the request of Company, shall immediately remove a Medical Director from Facility for cause, as “cause” is defined in Section 2.3.8 hereof.

The term “Medical Provider” as used in this Agreement shall include the Medical Director, provided that any provision that relates specifically to professional medical services will not apply to the Medical Director to the extent that the Medical Director is providing only administrative and not professional services.


Schedule 3.1

Compensation

Practice acknowledges that Practice may sometimes bill separately for the services of Medical Providers, and at other times Company submits global bills for the services of both the Facility and the Medical Providers. In light of the foregoing, Company shall pay to Practice the fees set forth below for services provided by the Medical Providers at the Facility to the extent that such provider services are not separately billed by Practice. To the extent Practice bills separately for Medical Provider services, Company shall not be obligated to pay a fee for such services.

 

Provider

   Fee

Physician/Psychologist Clinical Services

   $125 - $ 175 per hour*

Medical Director Services

   $ 100 - $ 150 per hour*

Mid-level Provider Services (PA or NP)

   $ 55 - $ 95 per hour*

 

* Specific hourly rate within the noted range shall be determined by Company in its reasonable discretion after consultation with Practice, based on the experience level, specialty, certifications, and other qualifications of the applicable practitioner.

If Practice is asked by Company to provide additional practitioner services at the Facility, Company shall pay to Practice a fee for such services equal to the rate that Practice pays such provider for the services (unless the service is separately billable by Practice). Practice represents and warrants that the compensation it pays to Medical Providers, and the corresponding fees paid by Company, shall be reasonable and consistent with fair market value. Compensation shall be paid pursuant to Company’s standard payment policies and timing.


Schedule 7.2

HIPAA Business Associate Addendum

This HIPAA Business Associate Addendum (“ Addendum ”) amends and is made part of that certain Professional Services Agreement for Medical Staffing (“ Service Agreement ”), by and between Singer Island Recovery Center LLC d/b/a The Academy (“ Entity ”) and Palm Beach Professional Group, Professional Corporation (“ Associate ”) to the extent that Associate is acting as a Business Associate of Entity.

Entity and Associate agree that the parties incorporate this Addendum into the Service Agreement in order to comply with the requirements of: the Health Insurance Portability and Accountability Act of 1996 (“ HIPAA ”), the Health Information Technology for Economic and Clinical Health Act (“ HITECH ”) and their implementing regulations set forth at 45 C.F.R. Parts 160 and Part 164 (the “ HIPAA Rules ”); and Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2 (“ Part 2 Regulations ”). To the extent Associate is acting as a Business Associate of Entity pursuant to the Service Agreement, the provisions of this Addendum shall apply, and Associate shall be subject to the penalty provisions of HIPAA as specified in 45 C.F.R. Part 160.

1. Definitions . Capitalized terms not otherwise defined in this Addendum shall have the meaning set forth in the HIPAA Rules. References to “PHI” mean Protected Health Information maintained, created, received or transmitted by Associate from Entity or on Entity’s behalf.

2. Uses or Disclosures . Associate will neither use nor disclose PHI except as permitted or required by this Addendum or as Required By Law. To the extent Associate is to carry out an obligation of Entity under the HIPAA Rules, Associate shall comply with the requirements of the HIPAA Rules that apply to Entity in the performance of such obligation. Without limiting the foregoing, Associate will not sell PHI or use or disclose PHI for purposes of marketing or fundraising, as defined and proscribed in the HIPAA Rules. Associate is permitted to use and disclose PHI:

(a) to perform any and all obligations of Associate as described in the Service Agreement, provided that such use or disclosure is consistent with the terms of Entity’s notice of privacy practices and would not violate the HIPAA Rules or the Part 2 Regulations, if done by Entity directly;

(b) to perform Data Aggregation services relating to the health care operations of Entity, provided that such services are part of Associate’s obligations as set forth in the Service Agreement;

(c) to create de-identified information in accordance with 45 C.F.R. § 164.514(b), provided that such de-identified information may be used and disclosed only consistent with applicable law; and

(d) as necessary for Associate’s proper management and administration and to carry out Associate’s legal responsibilities (collectively “ Associate’s Operations ”) provided that: any


disclosure made for purposes of Associate’s Operations is Required By Law or is made after Associate obtains reasonable assurances, evidenced by a written contract, from the recipient that the recipient: (i) will hold such PHI in confidence and use or further disclose it only for the purpose for which Associate disclosed it to the recipient or as Required By Law; (ii) will notify Associate of any instance of which the recipient becomes aware in which the confidentiality of such PHI was breached; (iii) acknowledges in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations; and (iv) agrees to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations. Associate shall promptly notify Entity of any disclosures made for purposes of Associate’s Operations.

In the event Entity notifies Associate of a restriction request that would restrict a use or disclosure otherwise permitted by this Addendum, Associate shall comply with the terms of the restriction request.

3. Safeguards . Associate will use appropriate administrative, technical and physical safeguards to prevent the use or disclosure of PHI other than as permitted by this Addendum and shall maintain policies and procedures to detect, prevent, and mitigate identity theft based on PHI or information derived from PHI. Associate will also comply with the provisions of 45 C.F.R. Part 164, Subpart C of the HIPAA Rules with respect to electronic PHI to prevent any use or disclosure of such information other than as provided by this Addendum, which obligation shall include maintaining safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI.

4. Policies and Training . Associate has policies in place regarding the confidential and secure treatment of PHI in accordance with HIPAA and the Part 2 Regulations. Associate shall require its employees to adhere to such policies and shall train its employees regarding the requirements of this Addendum and applicable confidentiality and security laws and regulations.

5. Subcontractors . In accordance with 45 C.F.R. § 164.308(b)(2) and 164.502(e)(1)(ii), Associate will ensure that all of its subcontractors that create, receive, maintain or transmit PHI on behalf of Associate agree by written contract to comply with the same restrictions and conditions that apply to Associate with respect to such PHI, including but not limited to (i) the obligation to safeguard PHI and comply with 45 C.F.R. Part 164, Subpart C; and (ii) acknowledging in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations, and must agree to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations.

6. Minimum Necessary . Associate represents that the PHI requested, used or disclosed by Associate shall be the minimum amount necessary to carry out the purposes of the Service Agreement. Associate will limit its uses and disclosures of, and requests for, PHI to the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request.

7. Obligations of Entity . Entity shall notify Associate of (i) any limitations in its notice of privacy practices, (ii) any changes in, or revocation of, permission by an individual to use or disclose PHI, and (iii) any confidential communication request or restriction on the use or disclosure of PHI that Entity has agreed to or with which Entity is required to comply, to the extent any of the foregoing affect Associate’s use or disclosure of PHI to perform its obligations as described in the Service Agreement.


8. Access and Amendment . In accordance with 45 C.F.R. § 164.524, Associate will permit Entity or, at Entity’s request, an individual (or the individual’s designee) to inspect and obtain copies of any PHI about the individual that is in Associate’s custody or control and that is maintained in a Designated Record Set. If the requested PHI is maintained electronically, Associate must provide a copy of the PHI in the electronic form and format requested by the individual, if it is readily producible, or, if not, in a readable electronic form and format as agreed to by Entity and the individual. Associate will notify Entity of any request (including but not limited to subpoenas) that Associate receives for access to PHI that is in Associate’s custody or control within five (5) business days of receipt of such request. Entity shall be responsible for making determinations about access. Associate will, upon receipt of notice from Entity, promptly amend or permit Entity access to amend any portion of the PHI that is in Associate’s custody or control so that Entity may meet its amendment obligations under 45 C.F.R. § 164.526.

9. Disclosure Accounting . Except for disclosures excluded from the accounting obligation by the HIPAA Rules and regulations issued pursuant to HITECH, Associate will record for each disclosure that Associate makes of PHI the information necessary for Entity to make an accounting of disclosures pursuant to the HIPAA Rules. In the event the U.S. Department of Health and Human Services (“ HHS ”) finalizes regulations requiring Covered Entities to provide access reports, Associate shall also record such information with respect to electronic PHI held by Associate as would be required under the regulations for Covered Entities beginning on the effective date applicable to Entity. Associate will make information required by this Section 9 available to Entity promptly upon Entity’s request for the period requested, but for no longer than the six (6) years preceding Entity’s request for the information or such other period required by the HIPAA Rules (except Associate need not have any information for disclosures occurring before the effective date of any previous HIPAA business associate agreements between the parties or, if none, the effective date of this Addendum).

10. Inspection of Books and Records . Associate will make its internal practices, books, and records, relating to its use and disclosure of PHI available upon request to Entity or HHS to determine Entity’s compliance with the HIPAA Rules.

11. Reporting . To the extent Associate becomes aware or discovers any use or disclosure of PHI not permitted by this Addendum, any Security Incident involving electronic PHI, any Breach of Unsecured Protected Health Information or any Red Flag (as defined at 16 C.F.R. § 681.2(b)) related to any individual who is the subject of PHI, Associate shall promptly report such use, disclosure, Security Incident, Breach or Red Flag to Entity. Associate shall mitigate, to the extent practicable, any harmful effect known to it of a Security Incident, Breach or use or disclosure of PHI by Associate not permitted by this Addendum. Notwithstanding the foregoing, the parties acknowledge and agree that this Section 11 constitutes notice by Associate to Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents (as defined below) for which no additional notice to Entity shall be required. “Unsuccessful Security Incidents” shall include, but not be limited to, pings and other broadcast attacks on Associate’s firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or


disclosure of electronic PHI. All reports of Breaches shall be made within ten (10) business days of Associate discovering the Breach and shall comply with and include the information specified at 45 C.F.R. § 164.410. Associate shall promptly reimburse Entity all reasonable costs incurred by Entity with respect to providing notification of and mitigating a Breach involving Associate, including but not limited to printing, postage costs and toll-free hotline costs.

12. Confidentiality of Alcohol and Drug Abuse Patient Records . Associate: (1) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from Entity about individuals who are patients of Entity (“ Patients ”), it is fully bound by the provisions of the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2; and (2) undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to Patients otherwise than as expressly provided for in the Part 2 Regulations.

13. Term and Termination . This Addendum shall be effective as of the effective date of the Service Agreement and shall remain in effect until termination of the Service Agreement. Either party may terminate this Addendum and the Service Agreement effective immediately if it determines that the other party has breached a material provision of this Addendum and failed to cure such breach within thirty (30) days of being notified by the other party of the breach. If the non-breaching party determines that cure is not possible, such party may terminate this Addendum and the Service Agreement effective immediately upon written notice to other party.

Upon termination of this Addendum for any reason, Associate will, if feasible, return to Entity or securely destroy all PHI maintained by Associate in any form or medium, including all copies of such PHI, at no cost to Entity. Further, Associate shall recover any PHI in the possession of its agents and subcontractors and return to Entity or securely destroy all such PHI. Notwithstanding the foregoing, Associate shall notify Entity and receive Entity’s written consent prior to destroying any PHI of which Entity does not maintain a duplicate copy. In the event that Associate determines that returning or destroying any PHI is infeasible, Associate shall promptly notify Entity of the conditions that make return or destruction infeasible. With regard to any PHI that Entity agrees cannot feasibly be returned to Entity or destroyed, Associate may maintain such PHI but shall continue to abide by the terms and conditions of this Addendum with respect to such PHI and shall limit its further use or disclosure of such PHI to those purposes that make return or destruction of the PHI infeasible. Associate shall comply with this Section 13 within thirty (30) days of termination of this Addendum. Associate shall provide Entity with written certification of its compliance with this Section 13 within forty-five (45) days of termination of this Addendum. Upon termination of this Addendum for any reason, all of Associate’s obligations under this Addendum shall survive termination and remain in effect (a) until Associate has completed the return or destruction of PHI as required by this Section 13 and (b) to the extent Associate retains any PHI pursuant to this Section 13 .

14. General Provisions . In the event that any final regulation or amendment to final regulations is promulgated by HHS or other government regulatory authority with respect to PHI, this Addendum will automatically be amended to remain in compliance with such regulations, and Associate shall promptly amend its contracts, if any, with subcontractors and agents to conform to the terms of this Addendum. Any ambiguity in this Addendum shall be resolved to permit Entity to comply with the HIPAA Rules and the Part 2 Regulations. Nothing


in this Addendum shall be construed to create any rights or remedies in any third parties or any agency relationship between the parties. A reference in this Addendum to a section in the HIPAA Rules or the Part 2 Regulations means the section as in effect or as amended. This Addendum replaces and supersedes and previous business associate agreements between the parties. The terms and conditions of this Addendum override and control any conflicting term or condition of the Service Agreement. To the extent Associate has limited its liability under the terms of the Service Agreement by a maximum recovery for direct damages, disclaimer against any consequential, indirect or punitive damages or any other limitation, all limitations shall exclude any damages to Entity arising from Associate’s breach of its obligations under this Addendum. All non-conflicting terms and conditions of the Service Agreement remain in full force and effect.

Exhibit 10.43

PROFESSIONAL SERVICES AGREEMENT

For Medical Staffing

THIS PROFESSIONAL SERVICES AGREEMENT for Medical Staffing (“ Agreement ”) is made this 5 th day of August, 2014 (the “ Effective Date ”), between Las Vegas Professional Group – Calarco, P.C. (“ Practice ), a professional corporation organized under the laws of Nevada, and Concorde Treatment Center, LLC d/b/a Desert Hope Center, a Nevada limited liability company (“ Company ”) (individually, a “ Party ,” and, collectively, the “ Parties ”).

W I TN E S S E T H:

WHEREAS , Company has established and operates an addiction treatment facility, Concorde Treatment Center, LLC d/b/a Desert Hope Center (“ Facility ”), located at 2465 E. Twain Avenue, Las Vegas, Nevada 89121;

WHEREAS , Practice employs Medical Providers and other medical personnel specializing in the treatment of various addictions;

WHEREAS , Practice is owned by a physician licensed to practice medicine in the state of Nevada (the “ State ”); and

WHEREAS , Company desires to engage Practice as of the Effective Date to provide, or arrange the provision of, medical services on behalf of Company, and Practice desires to accept such engagement as of the Effective Date, all upon the terms and conditions set forth in this Agreement.

NOW , THEREFORE , for and in consideration of the mutual agreements, covenants, terms and conditions herein contained, the Parties agree as follows:

ARTICLE I

ESTABLISHMENT OF PROFESSIONAL RELATIONSHIP

1.1 Engagement of Practice . As of the Effective Date, Company engages Practice, and Practice accepts said engagement, to provide medical services in accordance with the terms and conditions of this Agreement.

1.2 Relationship of the Parties . In the performance of their respective duties and obligations hereunder, the Parties are independent contractors, and as such they shall remain professionally and economically independent of each other. The Parties are not, and shall not be deemed to be, joint venturers, partners, employees, or agents of each other (except with respect to an agency for billing and collection activities expressly addressed in this Agreement). Neither Party shall have any authority to bind or incur any financial obligations on behalf of the other without the other’s express written consent, and then only insofar as such authority is conferred by such express written consent.


ARTICLE II

PRACTICE’S OBLIGATIONS

2.1 General Obligations . Practice shall provide the Medical Provider services set forth on Schedule 2.1 , attached hereto and incorporated herein by reference.

2.2 Responsibility for Medical Provider Services . Practice shall control and be responsible for the provision of medical services to Patients (as such term is defined on S chedule 2.1 ), and Company shall not engage in the practice of medicine nor shall it intervene or interfere in professional medical judgment of Practice or any Medical Provider; provided , however, that Practice shall cause the Medical Providers to comply with Company’s systems and procedures for review and improvement of the delivery of care.

2.3 Qualifications and Standards . Practice shall take all necessary actions to ensure that each Medical Provider satisfies the following conditions at all times during the Term:

2.3.1 Licensure and Experience Levels . Each Medical Provider shall maintain an unrestricted license to practice his or her specialty in the State and at all times shall be in good standing with the appropriate licensing board. Each Medical Provider shall have a level of competence, experience and skill at least comparable to that prevailing in the community.

2.3.2 Federal DEA Number . The Medical Providers shall maintain a Federal DEA number without restrictions, to the extent necessary for his or her practice.

2.3.3 Medical Standards . Each Medical Provider shall perform all medical services to be provided hereunder in accordance with the current standards of care in the medical community and any credentialing and quality criteria that are adopted from time to time by Company, the Facility and/or Practice

2.3.4 Continuing Education . Medical Providers shall participate in such continuing medical education and training programs as required by law to maintain skills compatible with standards of medical care in the community.

2.3.5 Bylaws . Medical Providers shall comply with any bylaws, policies, rules or regulations of Facility or Company, as may be amended from time to time.

2.3.6 Laws . Medical Providers shall comply with all applicable standards, rulings, regulations and requirements of the United States Department of Health and Human Services, the State’s department of health, the applicable accreditation agency of the Facility, and any federal, state or local government agency, third party payor or accrediting body having jurisdiction over or providing reimbursement for the Facility and any programs and services offered by either the Facility or Company.

2.3.7 Cooperation . Practice shall promptly notify Company if a claim of malpractice or professional discipline is asserted against any Medical Provider resulting from medical services provided at Facility; additionally Practice shall notify Company of claims not yet asserted against Medical Providers, but the potential for which Practice is aware.

 

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2.3.8 Approval and Removal . Each Medical Provider shall be subject to the initial approval of Company before he or she commences providing services at Facility. In addition, Practice, at the request of Company, shall immediately remove a Medical Provider from Facility for cause. For purposes of this Section 2.3.8 , “for cause” shall be determined by Company acting reasonably and in good faith and shall include the following: (a) suspension or revocation or other sanction of his or her medical license, specialty board certification, or Federal Drug Enforcement Agency (“ DEA ”) registration; (b) suspension, revocation, or reduction of his or her status or privileges as a member of the medical staff of any hospital utilized by Company for Patients served by the Medical Providers (including without limitation any resignation of membership or privileges in lieu of or to avoid any of the foregoing actions); (c) being arrested or indicted for, or convicted of any felony or any criminal charge relating to the practice of medicine; (d) being found by the appropriate licensure board or other state or federal regulatory agency to have violated any provision of law or the applicable code of medical ethics; (e) cancellation, termination or non-renewal of his or her professional liability insurance and failure to obtain replacement coverage within thirty (30) days; or (f) having committed any actions or inactions which pose an immediate and significant threat to Patients.

2.4 Compensation Responsibility . Practice shall be solely responsible for establishing and paying the compensation and fringe benefits, if any, to the Medical Providers. Practice shall be solely responsible for the payment and withholding of appropriate amounts for income tax, social security, unemployment insurance, and state disability insurance taxes. Practice shall also maintain in full force and effect all worker’s compensation insurance as may be required under the worker’s compensation laws of the State.

2.5 Medical Provider Staffing Levels . As of the Effective Date, Practice shall assign to Facility Medical Providers necessary to satisfy the patient needs at the Facility.

2.6 Authority . Practice has the right to enter into this Agreement, and neither the execution of this Agreement nor Practice’s performance hereunder will result in it being in breach or default of any existing agreement.

ARTICLE III

COMPENSATION

3.1 General Compensation Principles . Practice shall be compensated for the services provided hereunder pursuant to the terms of this Agreement as described in Schedule 3.1 , which is attached hereto and incorporated herein by reference. The Parties hereby acknowledge and agree that such amount represents the fair market value of the services provided hereunder.

ARTICLE IV

PATIENT CHARGES, BILLING AND COLLECTION

4.1 Billing; Assignment of Fees . Company, directly or through an affiliate, shall bill payors and patients for all technical and facility fees of the Facility. In addition, to the extent permissible by applicable law and third party payor policies, Company may (directly or through an affiliate) bill payors and patients globally for Company’s services and also the professional

 

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services of Practice and the Medical Providers that are provided pursuant to this Agreement. Practice authorizes Company, directly or through an affiliate, to bill and collect all professional fees of Practice and the Medical Providers, as Practice’s and the Medical Providers’ agent and attorney-in-fact to the extent permitted by applicable law for all services rendered by Practice or the Medical Providers at the Facility or on behalf of Company hereunder, either in Company’s own name or in Practice’s or individual Medical Provider’s name and provider number. Practice shall ensure that each Medical Provider executes such documentation as may be necessary to permit such billing by Company. To the extent that it is not allowable by law or payor policies for Company to bill for services on behalf of Practice or Medical Providers, Practice will bill in its own name for such services, provided that Practice intends to engage American Addiction Centers, Inc., an affiliate of Company, to provide billing support services. Practice shall ensure that duplicative billing does not occur, and neither it nor any Medical Provider will payors or patients for the same services that are billed by Company.

4.2 Practice to Provide Billing Information . For all applicable services described in Section 4.1 above and in accordance with applicable law, Practice shall provide Company with all billing information for services rendered by the Medical Providers, including, but not limited to, the name of the Patient, the date of service, the nature and extent of services provided, Patient diagnosis, and any supporting medical and non-medical information necessary to bill such services and to obtain payment and/or reimbursement. Each Medical Provider shall provide the above-described billing information to Company within seven (7) calendar days after the applicable medical services are rendered. The applicable treating Medical Provider shall be responsible for appropriately coding the service provided and supplying the correct CPT, KEY, ICD-9 (or ICD-10 once applicable) or other codes associated with the service.

ARTICLE V

INSURANCE

5.1 Comprehensive General Liability and Property Insurance . Company shall procure and maintain during the Term of this Agreement comprehensive general liability insurance covering its activities relating to Facility and property insurance covering the Facility. The comprehensive general liability insurance maintained hereunder shall be in amounts deemed sufficient by Company to protect against risks and losses associated with the operations of Facility.

5.2 Company’s Professional Liability Insurance . Company shall procure and maintain in full force and effect during the Term of this Agreement professional liability insurance covering Company and appropriate personnel provided by Company pursuant to this Agreement, including, without limitation, Company’s provider employees and contractors (subject to prior approval of insurer), against errors and omissions arising from Patient services and/or non-medical services rendered by Company pursuant to this Agreement. All premiums, costs and expenses associated with such professional liability insurance shall be borne by and paid by Company. The professional liability insurance procured by Company shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate. For purposes of Sections 5.1 and 5.2 , the term “insurance” shall include self-insurance arrangements maintained by Company for itself and its corporate affiliates, including Facility.

 

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5.3 Practice’s Professional Liability Insurance . Practice shall procure and maintain in full force and effect during the Term of this Agreement, and for a period of three (3) years subsequent to the expiration or earlier termination of this Agreement, professional liability insurance (i.e., medical malpractice insurance) with an insurer acceptable to Company, protecting Practice and its shareholders, officers, directors, and the Medical Providers against errors and omissions arising from professional services and/or medical services rendered by Practice and the Medical Providers. Such policy of insurance shall name Company as an additional insured. The insurance required by this Section 5.3 shall specifically extend to acts or omissions of Medical Providers occurring both prior and subsequent to the Effective Date. All premiums, costs and expenses associated with such professional liability insurance shall be borne by Practice. The professional liability insurance required by this Section 5.3 shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate.

5.4 Proof of Insurance . At the request of the other Party, each Party shall furnish copies of or Certificates of Insurance on all policies required under this Article V (or evidence of self-insurance) as evidence of the insurance coverage to be procured pursuant to this Agreement. In the case of Company, this evidence shall also specifically include evidence of “tail” or other coverage for acts and omissions occurring prior to the Effective Date. The insurance coverage required under this Agreement shall not be canceled, modified, reduced or otherwise materially changed, except upon thirty (30) days’ prior written notice to the non-procuring Party.

ARTICLE VI

INDEMNIFICATION

6.1 Indemnification by Company . Company shall indemnify, defend and hold Practice, and the shareholders, directors, officers and employees of Practice, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs, and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly from any negligent or willful act or omission of Company or its non-Medical Provider employees providing services at Facility. Notwithstanding any provisions of the preceding sentence to the contrary, Company shall not be liable to Practice for any consequential, exemplary or punitive damages. The duty of Company to indemnify, defend and hold harmless Practice shall only apply to the extent that any such loss sustained by Practice is not covered by insurance. The indemnification provisions of this Section 6.1 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other.

6.2 Indemnification by Practice . Practice shall indemnify, defend and hold Company, and the shareholders, directors, officers and employees of Company, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly, from any negligent or willful act or omission of any Medical Provider, including, specifically, (i) negligent or willful acts occurring both prior to and subsequent to the Effective Date and (ii) claims against Company attributable directly or indirectly to incorrect billing information provided to Company by Practice or any Medical Provider. Notwithstanding any provisions of the preceding sentence to the contrary, Practice shall not be liable to Company for any

 

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consequential, exemplary or punitive damages. The indemnification provisions of this Section 6.2 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other. A provision similar to that set forth in this Section 6.2 shall be contained in each contract between Practice and any independent contractor providing professional medical services for Practice at the Facility in order to ensure that each such Medical Provider has agreed to indemnify Company as required by this Section 6.2 .

ARTICLE VII

RECORDS AND CONFIDENTIALITY

7.1 Ownership of Records and Files . All business or medical records and files of whatever nature or kind, including Patients’ files and x-rays, are the property of Company to the extent permitted by law; neither Practice nor individual Medical Providers shall acquire any proprietary rights with respect to such records. However, at Practice’s written request, Company shall provide Medical Providers with copies of any records reflecting services performed by such Medical Provider with respect to (a) any claims against him/her in the nature of malpractice, (b) any charges against him/her issued by a licensing board or professional association or (c) for any other purpose deemed appropriate by Company

7.2 Confidentiality of Medical Records . Both Parties shall comply with all applicable federal and state laws and regulations regarding the confidential and secure treatment of individually identifiable health information, including 42 C.F.R. Part 2, and with the terms of the Business Associate Addendum attached as Schedule 7.2 hereto and incorporated herein by reference.

7.3 Medical Records upon Termination . Upon the expiration or earlier termination of this Agreement, unless a Patient specifies otherwise and in accordance with applicable law, Company shall be entitled to the original medical records for all Patients, and Practice shall be entitled to copy such records, with the cost of any copies to be home by Practice. For such period as is required by applicable statutes, Company shall keep possession of the original medical records and shall retain the records in their original condition, shall store the records in a safe place and make the records available to Practice without charge if reasonably necessary for any purpose, including, without limitation, Patient care and medical malpractice defense.

ARTICLE VIII

TERM AND TERMINATION

8.1 Term . This Agreement shall be effective for a term of five (5) years, beginning on the Effective Date, unless terminated pursuant to the provisions of this Article VIII (the “ Initial Term ”). Upon expiration of the Initial Term, this Agreement will automatically renew for additional one (1) year terms (the “ Renewal Terms ”) unless either Party shall provide notice to the other Party of its intent to terminate the Agreement under the terms of this Section 8.1 (“ Notice of Intent to Terminate ”). Notice of Intent to Terminate must be provided no later than one (1) year prior to the expiration of the Initial Term, and no later than ninety (90) days prior to the expiration of any Renewal Term.

 

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8.2 Termination upon Insolvency . If either Party shall apply for or consent to the appointment of a receiver, trustee or liquidation of itself, or if all or a substantial part of its assets, file a voluntary petition in bankruptcy or admit in writing its inability to pay its debts as they become due, make a general assignment for the benefit of creditors, file a petition or an answer seeking reorganization or arrangement with creditors, or take advantage of any insolvency law, or if an order, judgment, or decree shall be entered by a court of competent jurisdiction or an application of a creditor, adjudicating such party to be bankrupt or insolvent, or approving a petition seeking reorganization of such Party or appointing a receiver, trustee or liquidator of such Party or of all or a substantial part of its assets, and such order, judgment, or decree shall continue in effect and unstayed for a period of thirty (30) consecutive days, then the other Party may terminate this Agreement upon ten (10) days prior written notice to such Party.

8.3 Termination upon Legal Prohibitions of Relationship . If counsel jointly selected by the Parties should determine (the “ Determination ”) that it is more likely than not that applicable legislation, regulations, rules or procedures (collectively referred to herein as a “ Law ”) in effect or to become effective as of a date certain, or if Practice or Company receives notice (the “ Notice ”) of an actual or threatened decision, finding or action by any governmental or private agency or court (collectively referred to herein as an “ Action ”), which Law or Action, if or when implemented, would have the effect of subjecting either Party to civil or criminal prosecution under state and/or federal Laws, or other adverse proceeding on the basis of their participation herein, then the Parties shall attempt in good faith to amend this Agreement to the extent necessary in order to comply with such Law or to avoid the Action, as applicable. If, within ninety (90) days of providing written notice of such Determination or Notice to the other Party, the Parties acting in good faith are unable to mutually agree upon and make amendments or alterations to this Agreement to meet the requirements in question, or alternatively, the Parties mutually determine in good faith that compliance with such requirements is impossible or unfeasible, then this Agreement shall be terminated without penalty, charge or continuing liability upon the earlier of the following: the date one hundred eighty (180) days subsequent to the date upon which either Party gives written notice to the other Party or the effective date on which the Law or Action prohibits the relationship of the Parties pursuant to this Agreement.

8.4 Termination upon Breach . Either Party may elect to terminate this Agreement in the event that the other Party is in material breach of this Agreement and such default continues for a period of fifteen (15) calendar days after written notice thereof has been given to the Party in default by the other Party; provided , however, that Company may immediately terminate this Agreement if Practice fails to provide, or arrange the provision of, adequate professional medical services pursuant to this Agreement for a period of three (3) calendar days.

8.5 Termination Without Cause . This Agreement shall automatically terminate upon one hundred and eighty (180) days’ notice by either Party to the other Party.

8.6 Termination and Liabilities . In the event either Party validly elects to terminate this Agreement pursuant to the provisions of this Article VIII or the Agreement expires by its own terms, the liabilities and obligations of the Parties shall cease as of the date of termination, except that each Party shall be responsible for: (a) any payments or other obligations arising or accruing prior to the termination date and (b) any breach arising after termination or expiration with respect to obligations that continue after such expiration or termination. Neither Party shall

 

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be liable to the other for any damages resulting from any event of force majeure. The Parties agree that upon such termination, they will mutually work to assure an orderly transition of services.

ARTICLE IX

GENERAL PROVISIONS

9.1 Independence of Medical Judgment . Nothing in this Agreement shall affect the exercise of Medical Providers’ independent medical judgment.

9.2 Entire Agreement; Amendment . This Agreement constitutes the entire agreement between the Parties pertaining to the subject matter contained herein and supersedes all prior and contemporaneous agreements, representations and understandings of the Parties which relate to the subject matter of this Agreement. No supplement, amendment or modification of this Agreement shall be binding unless executed in writing by the Parties, unless otherwise provided herein.

9.3 No Waiver . No waiver of any of the provisions of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the Party making the waiver.

9.4 Subject Headings . The subject headings of the Articles and Sections of this Agreement are included for purposes of convenience only, and shall not affect the construction or interpretation of any of the provisions of this Agreement.

9.5 Binding Agreement; No Assignment . This Agreement shall be binding upon, and shall inure to the benefit of, the Parties and their respective legal representatives, successors and assigns. Company may assign this Agreement upon prior written notice to Practice. Practice may not assign this Agreement nor any rights hereunder, nor may it delegate any of the duties to be performed hereunder without the prior written consent of Company; provided , however, that notwithstanding the foregoing sentence to the contrary, Practice shall have the right to assign this Agreement to another corporate affiliate of Company upon written notice and shall have the right to subcontract with any other responsible parties, including specifically, corporate affiliates of Practice, for the performance of various aspects of its obligations hereunder, provided that Practice shall remain fully responsible for the performance of any such subcontractors.

9.6 Severability . Except as otherwise provided in Section 8.3 , in the event any provision of this Agreement is rendered invalid or unenforceable by the enactment of any applicable statute or ordinance or by any regulation duly promulgated or is made or declared unenforceable by any court of competent jurisdiction, the remainder of this Agreement shall remain in full force and effect.

9.7 Attorneys’ Fees . In the event any attorney is employed by any Party with regard to any legal action, arbitration or other proceeding brought by any Party for the enforcement of this Agreement, or because of an alleged dispute, breach, default or misrepresentation in connection with any of the provisions of this Agreement, then the prevailing Party, whether at trial or upon appeal, and in addition to any other relief to which the prevailing Party may be

 

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granted, shall be entitled to recover from the losing Party all costs, expenses and attorneys’ fees incurred by the prevailing Party in bringing or defending such action, arbitration or proceeding, and in enforcing any judgment granted therein, all of which costs, expenses and attorneys’ fees shall be deemed to have accrued upon the commencement of such action and shall be paid whether or not such action is prosecuted to judgment. Any judgment or order entered in such matter shall contain a specific provision providing for the recovery by the prevailing Party of attorneys’ fees, costs and expenses incurred in enforcing such judgment. For purposes of this Section 9.7 , attorneys’ fees shall include, without limitation, fees incurred in the following: post-judgment motions; contempt proceedings; garnishment, levy and debtor and third party examinations; discovery; and bankruptcy litigation.

9.8 Notices . All notices, requests, demands or other communications under this Agreement shall be in writing and shall be deemed to have been duly given on the date of service if served personally on the Party to whom notice is to be given, or on the third day after mailing if mailed to the Party to whom notice is to be given, by a recognized overnight carrier service, or by first class mail, registered or certified, postage prepaid, and properly addressed as follows:

 

TO PRACTICE:    Las Vegas Professional Group – Calarco, P.C.
   2465 E. Twain Avenue, Suite 100
   Las Vegas, Nevada 89121
   Attn: Mark A. Calarco, D.O.
TO COMPANY:    Concorde Treatment Center, LLC d/b/a Desert Hope Center
   2465 E. Twain Avenue
   Las Vegas, Nevada 89121
   Attn.: Chief Executive Officer
WITH COPY TO:   
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Candance A. Henderson-Grice, Chief Operating Officer
   Email: chenderson-grice@contactaac.com
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Kathryn Sevier Phillips, General Counsel and Secretary
   Fax: (615) 691-7130
   Email: ksphillips@contactaac.com

Each Party may change its address indicated above by giving the other Party written notice of the new address in the manner set forth above.

9.9 Governing Law . This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State. All actions, suits, or other proceedings with

 

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respect to this Agreement shall be brought only in a court of competent jurisdiction in the State. In any such action, suit, or proceeding, such court shall have personal jurisdiction over all of the parties hereto, and service of process upon them under any applicable statutes, laws, and rules shall be deemed valid and good.

9.10 Third Party Rights . This Agreement is entered into by and between the Parties hereto for their sole benefit. There is no intent by either Party to create or establish third party beneficiary status or rights in any third party to this Agreement and no third party shall have any right to enforce any right or enjoy any benefit created or established by this Agreement.

9.11 No Discrimination . No person shall be excluded from participation in, or be denied benefits of, or be otherwise subjected to discrimination in the performance of this Agreement or any Addenda on the grounds of disability, age, race, color, religion, sex, national origin or any other classification protected by federal and/or Tennessee constitutional, statutory and/or regulatory provisions.

9.12 Signatory . Each Party warrants that the person indicated on signatory line to this Agreement has all authority necessary to bind the Party and is the appropriate designated person to sign this Agreement.

9.13 Counterparts . This Agreement may be signed in multiple counterparts, each of which shall be deemed to be an original and all of which taken together shall constitute a single instrument.

9.14 Drafted Jointly . In the event of an ambiguity or question of intent or interpretation arises, this Agreement shall be construed as if drafted jointly by the Parties, and no presumption or burden of proof shall arise favoring or disfavoring any Party by virtue of authorship of the provisions of this Agreement.

9.15 Cooperation . The Parties agree to cooperate with each other to resolve promptly any outstanding financial, administrative or patient care issues upon the termination of this Agreement. Such obligation shall include, without limitation, the provision of patient, resident and/or administrative records, payments or other actions necessary to conclude the relationship of the Parties. This Section 9.15 shall survive the termination of this Agreement for any reason. Each Party further agrees to cooperate with the other to carry out the purpose and intent of this Agreement, including without limitation the execution and delivery to the appropriate Party of any further agreements and other documents and the taking of any action as may reasonably be required to effectuate the provisions of this Agreement.

[Signature Page Follows]

 

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IN WITNESS WHEREOF , the Parties hereto have duly executed this Agreement on the dates set forth below, provided that this Agreement is effective as of the Effective Date.

 

For Company:     For Practice:
Concorde Treatment Center, LLC     Las Vegas Professional Group – Calarco, P.C.
d/b/a Desert Hope Center    
By:  

/s/ Michael T. Cartwright

    By:  

/s/ Mark A. Calarco, D.O.

Name:   Michael T. Cartwright     Name:   Mark A. Calarco, D.O.
Title:   Manager     Title:   President, Secretary and Treasurer

 

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Schedule 2.1

Practice’s Services

Professional Services

During the term of this Agreement, Practice, through its physician shareholder, employees and independent contractors (the “ Medical Providers ”), shall provide professional medical services to the patients of Company (the “ Patients ”). Medical Providers may include doctors of medicine, doctors of osteopathy and mid-level providers including physician assistants and advanced practice nurses. Practice shall effectively provide all the professional medical services as required by Company for the needs of its Patients. Such professional medical services shall include those service obligations set forth herein and other related services reasonably requested by Company.

Medical Director Services

During the term of this Agreement, in addition to the professional services described above, Practice shall, unless otherwise agreed to by the parties, provide a physician who is acceptable to Company, to serve as medical director of Facility (the “ Medical Director ”) and provide medical management and oversight for matters specific to Facility pursuant to a medical director agreement between Practice and Medical Director reasonably acceptable to Company (the “ Medical Director Agreement ”). Practice shall cause Medical Director to furnish those services as set forth in the Medical Director Agreement, in accordance with the terms thereof. Upon request, Practice shall provide Company with documentation reasonably acceptable to Company supporting Medical Director’s fulfillment of such duties with Company also retaining the right to conduct such audits thereof as Company determines reasonably necessary to support Company’s payment for such services under this Agreement.

Practice shall provide support, assistance, and work cooperatively with Medical Director who will provide medical management and oversight for Facility. Practice, at the request of Company, shall immediately remove a Medical Director from Facility for cause, as “cause” is defined in Section 2.3.8 hereof.

The term “Medical Provider” as used in this Agreement shall include the Medical Director, provided that any provision that relates specifically to professional medical services will not apply to the Medical Director to the extent that the Medical Director is providing only administrative and not professional services.


Schedule 3.1

Compensation

Practice acknowledges that Practice may sometimes bill separately for the services of Medical Providers, and at other times Company submits global bills for the services of both the Facility and the Medical Providers. In light of the foregoing, Company shall pay to Practice the fees set forth below for services provided by the Medical Providers at the Facility to the extent that such provider services are not separately billed by Practice. To the extent Practice bills separately for Medical Provider services, Company shall not be obligated to pay a fee for such services.

 

Provider

   Fee

Physician/Psychologist Clinical Services

   $125 - $175 per hour*

Medical Director Services

   $100 - $150 per hour*

Mid-level Provider Services (PA or NP)

   $55 - $95 per hour*

 

* Specific hourly rate within the noted range shall be determined by Company in its reasonable discretion after consultation with Practice, based on the experience level, specialty, certifications, and other qualifications of the applicable practitioner.

If Practice is asked by Company to provide additional practitioner services at the Facility, Company shall pay to Practice a fee for such services equal to the rate that Practice pays such provider for the services (unless the service is separately billable by Practice). Practice represents and warrants that the compensation it pays to Medical Providers, and the corresponding fees paid by Company, shall be reasonable and consistent with fair market value. Compensation shall be paid pursuant to Company’s standard payment policies and timing.


Schedule 7.2

HIPAA Business Associate Addendum

This HIPAA Business Associate Addendum (“ Addendum ”) amends and is made part of that certain Professional Services Agreement for Medical Staffing (“ Service Agreement ”), by and between Concorde Treatment Center, LLC d/b/a Desert Hope Center (“ Entity ”) and Las Vegas Professional Group – Calarco, P.C. (“ Associate ”) to the extent that Associate is acting as a Business Associate of Entity.

Entity and Associate agree that the parties incorporate this Addendum into the Service Agreement in order to comply with the requirements of: the Health Insurance Portability and Accountability Act of 1996 (“ HIPAA ”), the Health Information Technology for Economic and Clinical Health Act (“ HITECH ”) and their implementing regulations set forth at 45 C.F.R. Parts 160 and Part 164 (the “ HIPAA Rules ”); and Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2 (“ Part 2 Regulations ”). To the extent Associate is acting as a Business Associate of Entity pursuant to the Service Agreement, the provisions of this Addendum shall apply, and Associate shall be subject to the penalty provisions of HIPAA as specified in 45 C.F.R. Part 160.

1. Definitions . Capitalized terms not otherwise defined in this Addendum shall have the meaning set forth in the HIPAA Rules. References to “PHI” mean Protected Health Information maintained, created, received or transmitted by Associate from Entity or on Entity’s behalf.

2. Uses or Disclosures . Associate will neither use nor disclose PHI except as permitted or required by this Addendum or as Required By Law. To the extent Associate is to carry out an obligation of Entity under the HIPAA Rules, Associate shall comply with the requirements of the HIPAA Rules that apply to Entity in the performance of such obligation. Without limiting the foregoing, Associate will not sell PHI or use or disclose PHI for purposes of marketing or fundraising, as defined and proscribed in the HIPAA Rules. Associate is permitted to use and disclose PHI:

(a) to perform any and all obligations of Associate as described in the Service Agreement, provided that such use or disclosure is consistent with the terms of Entity’s notice of privacy practices and would not violate the HIPAA Rules or the Part 2 Regulations, if done by Entity directly;

(b) to perform Data Aggregation services relating to the health care operations of Entity, provided that such services are part of Associate’s obligations as set forth in the Service Agreement;

(c) to create de-identified information in accordance with 45 C.F.R. § 164.514(b), provided that such de-identified information may be used and disclosed only consistent with applicable law; and

(d) as necessary for Associate’s proper management and administration and to carry out Associate’s legal responsibilities (collectively “ Associate’s Operations ”) provided that: any


disclosure made for purposes of Associate’s Operations is Required By Law or is made after Associate obtains reasonable assurances, evidenced by a written contract, from the recipient that the recipient: (i) will hold such PHI in confidence and use or further disclose it only for the purpose for which Associate disclosed it to the recipient or as Required By Law; (ii) will notify Associate of any instance of which the recipient becomes aware in which the confidentiality of such PHI was breached; (iii) acknowledges in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations; and (iv) agrees to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations. Associate shall promptly notify Entity of any disclosures made for purposes of Associate’s Operations.

In the event Entity notifies Associate of a restriction request that would restrict a use or disclosure otherwise permitted by this Addendum, Associate shall comply with the terms of the restriction request.

3. Safeguards . Associate will use appropriate administrative, technical and physical safeguards to prevent the use or disclosure of PHI other than as permitted by this Addendum and shall maintain policies and procedures to detect, prevent, and mitigate identity theft based on PHI or information derived from PHI. Associate will also comply with the provisions of 45 C.F.R. Part 164, Subpart C of the HIPAA Rules with respect to electronic PHI to prevent any use or disclosure of such information other than as provided by this Addendum, which obligation shall include maintaining safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI.

4. Policies and Training . Associate has policies in place regarding the confidential and secure treatment of PHI in accordance with HIPAA and the Part 2 Regulations. Associate shall require its employees to adhere to such policies and shall train its employees regarding the requirements of this Addendum and applicable confidentiality and security laws and regulations.

5. Subcontractors . In accordance with 45 C.F.R. § 164.308(b)(2) and 164.502(e)(1)(ii), Associate will ensure that all of its subcontractors that create, receive, maintain or transmit PHI on behalf of Associate agree by written contract to comply with the same restrictions and conditions that apply to Associate with respect to such PHI, including but not limited to (i) the obligation to safeguard PHI and comply with 45 C.F.R. Part 164, Subpart C; and (ii) acknowledging in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations, and must agree to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations.

6. Minimum Necessary . Associate represents that the PHI requested, used or disclosed by Associate shall be the minimum amount necessary to carry out the purposes of the Service Agreement. Associate will limit its uses and disclosures of, and requests for, PHI to the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request.

7. Obligations of Entity . Entity shall notify Associate of (i) any limitations in its notice of privacy practices, (ii) any changes in, or revocation of, permission by an individual to use or disclose PHI, and (iii) any confidential communication request or restriction on the use or disclosure of PHI that Entity has agreed to or with which Entity is required to comply, to the extent any of the foregoing affect Associate’s use or disclosure of PHI to perform its obligations as described in the Service Agreement.


8. Access and Amendment . In accordance with 45 C.F.R. § 164.524, Associate will permit Entity or, at Entity’s request, an individual (or the individual’s designee) to inspect and obtain copies of any PHI about the individual that is in Associate’s custody or control and that is maintained in a Designated Record Set. If the requested PHI is maintained electronically, Associate must provide a copy of the PHI in the electronic form and format requested by the individual, if it is readily producible, or, if not, in a readable electronic form and format as agreed to by Entity and the individual. Associate will notify Entity of any request (including but not limited to subpoenas) that Associate receives for access to PHI that is in Associate’s custody or control within five (5) business days of receipt of such request. Entity shall be responsible for making determinations about access. Associate will, upon receipt of notice from Entity, promptly amend or permit Entity access to amend any portion of the PHI that is in Associate’s custody or control so that Entity may meet its amendment obligations under 45 C.F.R. § 164.526.

9. Disclosure Accounting . Except for disclosures excluded from the accounting obligation by the HIPAA Rules and regulations issued pursuant to HITECH, Associate will record for each disclosure that Associate makes of PHI the information necessary for Entity to make an accounting of disclosures pursuant to the HIPAA Rules. In the event the U.S. Department of Health and Human Services (“ HHS ”) finalizes regulations requiring Covered Entities to provide access reports, Associate shall also record such information with respect to electronic PHI held by Associate as would be required under the regulations for Covered Entities beginning on the effective date applicable to Entity. Associate will make information required by this Section 9 available to Entity promptly upon Entity’s request for the period requested, but for no longer than the six (6) years preceding Entity’s request for the information or such other period required by the HIPAA Rules (except Associate need not have any information for disclosures occurring before the effective date of any previous HIPAA business associate agreements between the parties or, if none, the effective date of this Addendum).

10. Inspection of Books and Records . Associate will make its internal practices, books, and records, relating to its use and disclosure of PHI available upon request to Entity or HHS to determine Entity’s compliance with the HIPAA Rules.

11. Reporting . To the extent Associate becomes aware or discovers any use or disclosure of PHI not permitted by this Addendum, any Security Incident involving electronic PHI, any Breach of Unsecured Protected Health Information or any Red Flag (as defined at 16 C.F.R. § 681.2(b)) related to any individual who is the subject of PHI, Associate shall promptly report such use, disclosure, Security Incident, Breach or Red Flag to Entity. Associate shall mitigate, to the extent practicable, any harmful effect known to it of a Security Incident, Breach or use or disclosure of PHI by Associate not permitted by this Addendum. Notwithstanding the foregoing, the parties acknowledge and agree that this Section 11 constitutes notice by Associate to Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents (as defined below) for which no additional notice to Entity shall be required. “Unsuccessful Security Incidents” shall include, but not be limited to, pings and other broadcast attacks on Associate’s firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or


disclosure of electronic PHI. All reports of Breaches shall be made within ten (10) business days of Associate discovering the Breach and shall comply with and include the information specified at 45 C.F.R. § 164.410. Associate shall promptly reimburse Entity all reasonable costs incurred by Entity with respect to providing notification of and mitigating a Breach involving Associate, including but not limited to printing, postage costs and toll-free hotline costs.

12. Confidentiality of Alcohol and Drug Abuse Patient Records . Associate: (1) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from Entity about individuals who are patients of Entity (“ Patients ”), it is fully bound by the provisions of the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2; and (2) undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to Patients otherwise than as expressly provided for in the Part 2 Regulations.

13. Term and Termination . This Addendum shall be effective as of the effective date of the Service Agreement and shall remain in effect until termination of the Service Agreement. Either party may terminate this Addendum and the Service Agreement effective immediately if it determines that the other party has breached a material provision of this Addendum and failed to cure such breach within thirty (30) days of being notified by the other party of the breach. If the non-breaching party determines that cure is not possible, such party may terminate this Addendum and the Service Agreement effective immediately upon written notice to other party.

Upon termination of this Addendum for any reason, Associate will, if feasible, return to Entity or securely destroy all PHI maintained by Associate in any form or medium, including all copies of such PHI, at no cost to Entity. Further, Associate shall recover any PHI in the possession of its agents and subcontractors and return to Entity or securely destroy all such PHI. Notwithstanding the foregoing, Associate shall notify Entity and receive Entity’s written consent prior to destroying any PHI of which Entity does not maintain a duplicate copy. In the event that Associate determines that returning or destroying any PHI is infeasible, Associate shall promptly notify Entity of the conditions that make return or destruction infeasible. With regard to any PHI that Entity agrees cannot feasibly be returned to Entity or destroyed, Associate may maintain such PHI but shall continue to abide by the terms and conditions of this Addendum with respect to such PHI and shall limit its further use or disclosure of such PHI to those purposes that make return or destruction of the PHI infeasible. Associate shall comply with this Section 13 within thirty (30) days of termination of this Addendum. Associate shall provide Entity with written certification of its compliance with this Section 13 within forty-five (45) days of termination of this Addendum. Upon termination of this Addendum for any reason, all of Associate’s obligations under this Addendum shall survive termination and remain in effect (a) until Associate has completed the return or destruction of PHI as required by this Section 13 and (b) to the extent Associate retains any PHI pursuant to this Section 13 .

14. General Provisions . In the event that any final regulation or amendment to final regulations is promulgated by HHS or other government regulatory authority with respect to PHI, this Addendum will automatically be amended to remain in compliance with such regulations, and Associate shall promptly amend its contracts, if any, with subcontractors and agents to conform to the terms of this Addendum. Any ambiguity in this Addendum shall be resolved to permit Entity to comply with the HIPAA Rules and the Part 2 Regulations. Nothing


in this Addendum shall be construed to create any rights or remedies in any third parties or any agency relationship between the parties. A reference in this Addendum to a section in the HIPAA Rules or the Part 2 Regulations means the section as in effect or as amended. This Addendum replaces and supersedes and previous business associate agreements between the parties. The terms and conditions of this Addendum override and control any conflicting term or condition of the Service Agreement. To the extent Associate has limited its liability under the terms of the Service Agreement by a maximum recovery for direct damages, disclaimer against any consequential, indirect or punitive damages or any other limitation, all limitations shall exclude any damages to Entity arising from Associate’s breach of its obligations under this Addendum. All non-conflicting terms and conditions of the Service Agreement remain in full force and effect.

Exhibit 10.44

PROFESSIONAL SERVICES AGREEMENT

For Medical Staffing

THIS PROFESSIONAL SERVICES AGREEMENT for Medical Staffing (“ Agreement ”) is made this 5 th day of August, 2014 (the “ Effective Date ”), between Brentwood Professional Group, P.C. (“ Practice ), a professional corporation organized under the laws of Tennessee, and FitRx, LLC, a Tennessee limited liability company (“ Company ”) (individually, a “ Party ,” and, collectively, the “ Parties ”).

W I TN E S S E T H:

WHEREAS , Company has established and operates an addiction treatment facility, FitRx, LLC (“ Facility ”), located at 204 Ward Circle, Suite 300, Brentwood, Tennessee 37027;

WHEREAS , Practice employs Medical Providers and other medical personnel specializing in the treatment of various addictions;

WHEREAS , Practice is owned by a physician licensed to practice medicine in the state of Tennessee (the “ State ”); and

WHEREAS , Company desires to engage Practice as of the Effective Date to provide, or arrange the provision of, medical services on behalf of Company, and Practice desires to accept such engagement as of the Effective Date, all upon the terms and conditions set forth in this Agreement.

NOW , THEREFORE , for and in consideration of the mutual agreements, covenants, terms and conditions herein contained, the Parties agree as follows:

ARTICLE I

ESTABLISHMENT OF PROFESSIONAL RELATIONSHIP

1.1 Engagement of Practice . As of the Effective Date, Company engages Practice, and Practice accepts said engagement, to provide medical services in accordance with the terms and conditions of this Agreement.

1.2 Relationship of the Parties . In the performance of their respective duties and obligations hereunder, the Parties are independent contractors, and as such they shall remain professionally and economically independent of each other. The Parties are not, and shall not be deemed to be, joint venturers, partners, employees, or agents of each other (except with respect to an agency for billing and collection activities expressly addressed in this Agreement). Neither Party shall have any authority to bind or incur any financial obligations on behalf of the other without the other’s express written consent, and then only insofar as such authority is conferred by such express written consent.


ARTICLE II

PRACTICE’S OBLIGATIONS

2.1 General Obligations . Practice shall provide the Medical Provider services set forth on Schedule 2.1 , attached hereto and incorporated herein by reference.

2.2 Responsibility for Medical Provider Services . Practice shall control and be responsible for the provision of medical services to Patients (as such term is defined on Schedule 2.1 ), and Company shall not engage in the practice of medicine nor shall it intervene or interfere in professional medical judgment of Practice or any Medical Provider; provided , however, that Practice shall cause the Medical Providers to comply with Company’s systems and procedures for review and improvement of the delivery of care.

2.3 Qualifications and Standards . Practice shall take all necessary actions to ensure that each Medical Provider satisfies the following conditions at all times during the Term:

2.3.1 Licensure and Experience Levels . Each Medical Provider shall maintain an unrestricted license to practice his or her specialty in the State and at all times shall be in good standing with the appropriate licensing board. Each Medical Provider shall have a level of competence, experience and skill at least comparable to that prevailing in the community.

2.3.2 Federal DEA Number . The Medical Providers shall maintain a Federal DEA number without restrictions, to the extent necessary for his or her practice.

2.3.3 Medical Standards . Each Medical Provider shall perform all medical services to be provided hereunder in accordance with the current standards of care in the medical community and any credentialing and quality criteria that are adopted from time to time by Company, the Facility and/or Practice

2.3.4 Continuing Education . Medical Providers shall participate in such continuing medical education and training programs as required by law to maintain skills compatible with standards of medical care in the community.

2.3.5 Bylaws . Medical Providers shall comply with any bylaws, policies, rules or regulations of Facility or Company, as may be amended from time to time.

2.3.6 Laws . Medical Providers shall comply with all applicable standards, rulings, regulations and requirements of the United States Department of Health and Human Services, the State’s department of health, the applicable accreditation agency of the Facility, and any federal, state or local government agency, third party payor or accrediting body having jurisdiction over or providing reimbursement for the Facility and any programs and services offered by either the Facility or Company.

2.3.7 Cooperation . Practice shall promptly notify Company if a claim of malpractice or professional discipline is asserted against any Medical Provider resulting from medical services provided at Facility; additionally Practice shall notify Company of claims not yet asserted against Medical Providers, but the potential for which Practice is aware.

 

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2.3.8 Approval and Removal . Each Medical Provider shall be subject to the initial approval of Company before he or she commences providing services at Facility. In addition, Practice, at the request of Company, shall immediately remove a Medical Provider from Facility for cause. For purposes of this Section 2.3.8 , “for cause” shall be determined by Company acting reasonably and in good faith and shall include the following: (a) suspension or revocation or other sanction of his or her medical license, specialty board certification, or Federal Drug Enforcement Agency (“ DEA ”) registration; (b) suspension, revocation, or reduction of his or her status or privileges as a member of the medical staff of any hospital utilized by Company for Patients served by the Medical Providers (including without limitation any resignation of membership or privileges in lieu of or to avoid any of the foregoing actions); (c) being arrested or indicted for, or convicted of any felony or any criminal charge relating to the practice of medicine; (d) being found by the appropriate licensure board or other state or federal regulatory agency to have violated any provision of law or the applicable code of medical ethics; (e) cancellation, termination or non-renewal of his or her professional liability insurance and failure to obtain replacement coverage within thirty (30) days; or (f) having committed any actions or inactions which pose an immediate and significant threat to Patients.

2.4 Compensation Responsibility . Practice shall be solely responsible for establishing and paying the compensation and fringe benefits, if any, to the Medical Providers. Practice shall be solely responsible for the payment and withholding of appropriate amounts for income tax, social security, unemployment insurance, and state disability insurance taxes. Practice shall also maintain in full force and effect all worker’s compensation insurance as may be required under the worker’s compensation laws of the State.

2.5 Medical Provider Staffing Levels . As of the Effective Date, Practice shall assign to Facility Medical Providers necessary to satisfy the patient needs at the Facility.

2.6 Authority . Practice has the right to enter into this Agreement, and neither the execution of this Agreement nor Practice’s performance hereunder will result in it being in breach or default of any existing agreement.

ARTICLE III

COMPENSATION

3.1 General Compensation Principles . Practice shall be compensated for the services provided hereunder pursuant to the terms of this Agreement as described in Schedule 3.1 , which is attached hereto and incorporated herein by reference. The Parties hereby acknowledge and agree that such amount represents the fair market value of the services provided hereunder.

ARTICLE IV

PATIENT CHARGES, BILLING AND COLLECTION

4.1 Billing; Assignment of Fees . Company, directly or through an affiliate, shall bill payors and patients for all technical and facility fees of the Facility. In addition, to the extent permissible by applicable law and third party payor policies, Company may (directly or through

 

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an affiliate) bill payors and patients globally for Company’s services and also the professional services of Practice and the Medical Providers that are provided pursuant to this Agreement. Practice authorizes Company, directly or through an affiliate, to bill and collect all professional fees of Practice and the Medical Providers, as Practice’s and the Medical Providers’ agent and attorney-in-fact to the extent permitted by applicable law for all services rendered by Practice or the Medical Providers at the Facility or on behalf of Company hereunder, either in Company’s own name or in Practice’s or individual Medical Provider’s name and provider number. Practice shall ensure that each Medical Provider executes such documentation as may be necessary to permit such billing by Company. To the extent that it is not allowable by law or payor policies for Company to bill for services on behalf of Practice or Medical Providers, Practice will bill in its own name for such services, provided that Practice intends to engage American Addiction Centers, Inc., an affiliate of Company, to provide billing support services. Practice shall ensure that duplicative billing does not occur, and neither it nor any Medical Provider will payors or patients for the same services that are billed by Company.

4.2 Practice to Provide Billing Information . For all applicable services described in Section 4.1 above and in accordance with applicable law, Practice shall provide Company with all billing information for services rendered by the Medical Providers, including, but not limited to, the name of the Patient, the date of service, the nature and extent of services provided, Patient diagnosis, and any supporting medical and non-medical information necessary to bill such services and to obtain payment and/or reimbursement. Each Medical Provider shall provide the above-described billing information to Company within seven (7) calendar days after the applicable medical services are rendered. The applicable treating Medical Provider shall be responsible for appropriately coding the service provided and supplying the correct CPT, KEY, ICD-9 (or ICD-10 once applicable) or other codes associated with the service.

ARTICLE V

INSURANCE

5.1 Comprehensive General Liability and Property Insurance . Company shall procure and maintain during the Term of this Agreement comprehensive general liability insurance covering its activities relating to Facility and property insurance covering the Facility. The comprehensive general liability insurance maintained hereunder shall be in amounts deemed sufficient by Company to protect against risks and losses associated with the operations of Facility.

5.2 Company’s Professional Liability Insurance . Company shall procure and maintain in full force and effect during the Term of this Agreement professional liability insurance covering Company and appropriate personnel provided by Company pursuant to this Agreement, including, without limitation, Company’s provider employees and contractors (subject to prior approval of insurer), against errors and omissions arising from Patient services and/or non-medical services rendered by Company pursuant to this Agreement. All premiums, costs and expenses associated with such professional liability insurance shall be borne by and paid by Company. The professional liability insurance procured by Company shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate. For purposes of Sections 5.1 and 5.2 , the term “insurance” shall include self-insurance arrangements maintained by Company for itself and its corporate affiliates, including Facility.

 

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5.3 Practice’s Professional Liability Insurance . Practice shall procure and maintain in full force and effect during the Term of this Agreement, and for a period of three (3) years subsequent to the expiration or earlier termination of this Agreement, professional liability insurance (i.e., medical malpractice insurance) with an insurer acceptable to Company, protecting Practice and its shareholders, officers, directors, and the Medical Providers against errors and omissions arising from professional services and/or medical services rendered by Practice and the Medical Providers. Such policy of insurance shall name Company as an additional insured. The insurance required by this Section 5.3 shall specifically extend to acts or omissions of Medical Providers occurring both prior and subsequent to the Effective Date. All premiums, costs and expenses associated with such professional liability insurance shall be borne by Practice. The professional liability insurance required by this Section 5.3 shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate.

5.4 Proof of Insurance . At the request of the other Party, each Party shall furnish copies of or Certificates of Insurance on all policies required under this Article V (or evidence of self-insurance) as evidence of the insurance coverage to be procured pursuant to this Agreement. In the case of Company, this evidence shall also specifically include evidence of “tail” or other coverage for acts and omissions occurring prior to the Effective Date. The insurance coverage required under this Agreement shall not be canceled, modified, reduced or otherwise materially changed, except upon thirty (30) days’ prior written notice to the non-procuring Party.

ARTICLE VI

INDEMNIFICATION

6.1 Indemnification by Company . Company shall indemnify, defend and hold Practice, and the shareholders, directors, officers and employees of Practice, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs, and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly from any negligent or willful act or omission of Company or its non-Medical Provider employees providing services at Facility. Notwithstanding any provisions of the preceding sentence to the contrary, Company shall not be liable to Practice for any consequential, exemplary or punitive damages. The duty of Company to indemnify, defend and hold harmless Practice shall only apply to the extent that any such loss sustained by Practice is not covered by insurance. The indemnification provisions of this Section 6.1 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other.

6.2 Indemnification by Practice . Practice shall indemnify, defend and hold Company, and the shareholders, directors, officers and employees of Company, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly, from any negligent or willful act or omission of any Medical Provider, including, specifically, (i) negligent or willful acts occurring both prior to and subsequent to the Effective Date and (ii)

 

5


claims against Company attributable directly or indirectly to incorrect billing information provided to Company by Practice or any Medical Provider. Notwithstanding any provisions of the preceding sentence to the contrary, Practice shall not be liable to Company for any consequential, exemplary or punitive damages. The indemnification provisions of this Section 6.2 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other. A provision similar to that set forth in this Section 6.2 shall be contained in each contract between Practice and any independent contractor providing professional medical services for Practice at the Facility in order to ensure that each such Medical Provider has agreed to indemnify Company as required by this Section 6.2 .

ARTICLE VII

RECORDS AND CONFIDENTIALITY

7.1 Ownership of Records and Files . All business or medical records and files of whatever nature or kind, including Patients’ files and x-rays, are the property of Company to the extent permitted by law; neither Practice nor individual Medical Providers shall acquire any proprietary rights with respect to such records. However, at Practice’s written request, Company shall provide Medical Providers with copies of any records reflecting services performed by such Medical Provider with respect to (a) any claims against him/her in the nature of malpractice, (b) any charges against him/her issued by a licensing board or professional association or (c) for any other purpose deemed appropriate by Company

7.2 Confidentiality of Medical Records . Both Parties shall comply with all applicable federal and state laws and regulations regarding the confidential and secure treatment of individually identifiable health information, including 42 C.F.R. Part 2, and with the terms of the Business Associate Addendum attached as Schedule 7.2 hereto and incorporated herein by reference.

7.3 Medical Records upon Termination . Upon the expiration or earlier termination of this Agreement, unless a Patient specifies otherwise and in accordance with applicable law, Company shall be entitled to the original medical records for all Patients, and Practice shall be entitled to copy such records, with the cost of any copies to be home by Practice. For such period as is required by applicable statutes, Company shall keep possession of the original medical records and shall retain the records in their original condition, shall store the records in a safe place and make the records available to Practice without charge if reasonably necessary for any purpose, including, without limitation, Patient care and medical malpractice defense.

ARTICLE VIII

TERM AND TERMINATION

8.1 Term . This Agreement shall be effective for a term of five (5) years, beginning on the Effective Date, unless terminated pursuant to the provisions of this Article VIII (the “ Initial Term ”). Upon expiration of the Initial Term, this Agreement will automatically renew for additional one (1) year terms (the “ Renewal Terms ”) unless either Party shall provide notice to the other Party of its intent to terminate the Agreement under the terms of this Section 8.1

 

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(“ Notice of Intent to Terminate ”). Notice of Intent to Terminate must be provided no later than one (1) year prior to the expiration of the Initial Term, and no later than ninety (90) days prior to the expiration of any Renewal Term.

8.2 Termination upon Insolvency . If either Party shall apply for or consent to the appointment of a receiver, trustee or liquidation of itself, or if all or a substantial part of its assets, file a voluntary petition in bankruptcy or admit in writing its inability to pay its debts as they become due, make a general assignment for the benefit of creditors, file a petition or an answer seeking reorganization or arrangement with creditors, or take advantage of any insolvency law, or if an order, judgment, or decree shall be entered by a court of competent jurisdiction or an application of a creditor, adjudicating such party to be bankrupt or insolvent, or approving a petition seeking reorganization of such Party or appointing a receiver, trustee or liquidator of such Party or of all or a substantial part of its assets, and such order, judgment, or decree shall continue in effect and unstayed for a period of thirty (30) consecutive days, then the other Party may terminate this Agreement upon ten (10) days prior written notice to such Party.

8.3 Termination upon Legal Prohibitions of Relationship . If counsel jointly selected by the Parties should determine (the “ Determination ”) that it is more likely than not that applicable legislation, regulations, rules or procedures (collectively referred to herein as a “ Law ”) in effect or to become effective as of a date certain, or if Practice or Company receives notice (the “ Notice ”) of an actual or threatened decision, finding or action by any governmental or private agency or court (collectively referred to herein as an “ Action ”), which Law or Action, if or when implemented, would have the effect of subjecting either Party to civil or criminal prosecution under state and/or federal Laws, or other adverse proceeding on the basis of their participation herein, then the Parties shall attempt in good faith to amend this Agreement to the extent necessary in order to comply with such Law or to avoid the Action, as applicable. If, within ninety (90) days of providing written notice of such Determination or Notice to the other Party, the Parties acting in good faith are unable to mutually agree upon and make amendments or alterations to this Agreement to meet the requirements in question, or alternatively, the Parties mutually determine in good faith that compliance with such requirements is impossible or unfeasible, then this Agreement shall be terminated without penalty, charge or continuing liability upon the earlier of the following: the date one hundred eighty (180) days subsequent to the date upon which either Party gives written notice to the other Party or the effective date on which the Law or Action prohibits the relationship of the Parties pursuant to this Agreement.

8.4 Termination upon Breach . Either Party may elect to terminate this Agreement in the event that the other Party is in material breach of this Agreement and such default continues for a period of fifteen (15) calendar days after written notice thereof has been given to the Party in default by the other Party; provided , however, that Company may immediately terminate this Agreement if Practice fails to provide, or arrange the provision of, adequate professional medical services pursuant to this Agreement for a period of three (3) calendar days.

8.5 Termination Without Cause . This Agreement shall automatically terminate upon one hundred and eighty (180) days’ notice by either Party to the other Party.

8.6 Termination and Liabilities . In the event either Party validly elects to terminate this Agreement pursuant to the provisions of this Article VIII or the Agreement expires by its

 

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own terms, the liabilities and obligations of the Parties shall cease as of the date of termination, except that each Party shall be responsible for: (a) any payments or other obligations arising or accruing prior to the termination date and (b) any breach arising after termination or expiration with respect to obligations that continue after such expiration or termination. Neither Party shall be liable to the other for any damages resulting from any event of force majeure. The Parties agree that upon such termination, they will mutually work to assure an orderly transition of services.

ARTICLE IX

GENERAL PROVISIONS

9.1 Independence of Medical Judgment . Nothing in this Agreement shall affect the exercise of Medical Providers’ independent medical judgment.

9.2 Entire Agreement; Amendment . This Agreement constitutes the entire agreement between the Parties pertaining to the subject matter contained herein and supersedes all prior and contemporaneous agreements, representations and understandings of the Parties which relate to the subject matter of this Agreement. No supplement, amendment or modification of this Agreement shall be binding unless executed in writing by the Parties, unless otherwise provided herein.

9.3 No Waiver . No waiver of any of the provisions of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the Party making the waiver.

9.4 Subject Headings . The subject headings of the Articles and Sections of this Agreement are included for purposes of convenience only, and shall not affect the construction or interpretation of any of the provisions of this Agreement.

9.5 Binding Agreement; No Assignment . This Agreement shall be binding upon, and shall inure to the benefit of, the Parties and their respective legal representatives, successors and assigns. Company may assign this Agreement upon prior written notice to Practice. Practice may not assign this Agreement nor any rights hereunder, nor may it delegate any of the duties to be performed hereunder without the prior written consent of Company; provided , however, that notwithstanding the foregoing sentence to the contrary, Practice shall have the right to assign this Agreement to another corporate affiliate of Company upon written notice and shall have the right to subcontract with any other responsible parties, including specifically, corporate affiliates of Practice, for the performance of various aspects of its obligations hereunder, provided that Practice shall remain fully responsible for the performance of any such subcontractors.

9.6 Severability . Except as otherwise provided in Section 8.3 , in the event any provision of this Agreement is rendered invalid or unenforceable by the enactment of any applicable statute or ordinance or by any regulation duly promulgated or is made or declared unenforceable by any court of competent jurisdiction, the remainder of this Agreement shall remain in full force and effect.

 

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9.7 Attorneys’ Fees . In the event any attorney is employed by any Party with regard to any legal action, arbitration or other proceeding brought by any Party for the enforcement of this Agreement, or because of an alleged dispute, breach, default or misrepresentation in connection with any of the provisions of this Agreement, then the prevailing Party, whether at trial or upon appeal, and in addition to any other relief to which the prevailing Party may be granted, shall be entitled to recover from the losing Party all costs, expenses and attorneys’ fees incurred by the prevailing Party in bringing or defending such action, arbitration or proceeding, and in enforcing any judgment granted therein, all of which costs, expenses and attorneys’ fees shall be deemed to have accrued upon the commencement of such action and shall be paid whether or not such action is prosecuted to judgment. Any judgment or order entered in such matter shall contain a specific provision providing for the recovery by the prevailing Party of attorneys’ fees, costs and expenses incurred in enforcing such judgment. For purposes of this Section 9.7 , attorneys’ fees shall include, without limitation, fees incurred in the following: post-judgment motions; contempt proceedings; garnishment, levy and debtor and third party examinations; discovery; and bankruptcy litigation.

9.8 Notices . All notices, requests, demands or other communications under this Agreement shall be in writing and shall be deemed to have been duly given on the date of service if served personally on the Party to whom notice is to be given, or on the third day after mailing if mailed to the Party to whom notice is to be given, by a recognized overnight carrier service, or by first class mail, registered or certified, postage prepaid, and properly addressed as follows:

 

TO PRACTICE:    Brentwood Professional Group, P.C.
   204 Ward Circle, Suite 300B
   Brentwood, Tennessee 37027
   Attn: Mark A. Calarco, D.O.
TO COMPANY:    FitRx, LLC
   204 Ward Circle, Suite 300
   Brentwood, Tennessee 37027
   Attn.: Chief Executive Officer
WITH COPY TO:   
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Candance A. Henderson-Grice, Chief Operating Officer
   Email: chenderson-grice@contactaac.com
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Kathryn Sevier Phillips, General Counsel and Secretary
   Fax: (615) 691-7130
   Email: ksphillips@contactaac.com

 

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Each Party may change its address indicated above by giving the other Party written notice of the new address in the manner set forth above.

9.9 Governing Law . This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State. All actions, suits, or other proceedings with respect to this Agreement shall be brought only in a court of competent jurisdiction in the State. In any such action, suit, or proceeding, such court shall have personal jurisdiction over all of the parties hereto, and service of process upon them under any applicable statutes, laws, and rules shall be deemed valid and good.

9.10 Third Party Rights . This Agreement is entered into by and between the Parties hereto for their sole benefit. There is no intent by either Party to create or establish third party beneficiary status or rights in any third party to this Agreement and no third party shall have any right to enforce any right or enjoy any benefit created or established by this Agreement.

9.11 No Discrimination . No person shall be excluded from participation in, or be denied benefits of, or be otherwise subjected to discrimination in the performance of this Agreement or any Addenda on the grounds of disability, age, race, color, religion, sex, national origin or any other classification protected by federal and/or Tennessee constitutional, statutory and/or regulatory provisions.

9.12 Signatory . Each Party warrants that the person indicated on signatory line to this Agreement has all authority necessary to bind the Party and is the appropriate designated person to sign this Agreement.

9.13 Counterparts . This Agreement may be signed in multiple counterparts, each of which shall be deemed to be an original and all of which taken together shall constitute a single instrument.

9.14 Drafted Jointly . In the event of an ambiguity or question of intent or interpretation arises, this Agreement shall be construed as if drafted jointly by the Parties, and no presumption or burden of proof shall arise favoring or disfavoring any Party by virtue of authorship of the provisions of this Agreement.

9.15 Cooperation . The Parties agree to cooperate with each other to resolve promptly any outstanding financial, administrative or patient care issues upon the termination of this Agreement. Such obligation shall include, without limitation, the provision of patient, resident and/or administrative records, payments or other actions necessary to conclude the relationship of the Parties. This Section 9.15 shall survive the termination of this Agreement for any reason. Each Party further agrees to cooperate with the other to carry out the purpose and intent of this Agreement, including without limitation the execution and delivery to the appropriate Party of any further agreements and other documents and the taking of any action as may reasonably be required to effectuate the provisions of this Agreement.

[Signature Page Follows]

 

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IN WITNESS WHEREOF , the Parties hereto have duly executed this Agreement on the dates set forth below, provided that this Agreement is effective as of the Effective Date.

 

For Company:     For Practice:
FitRx, LLC     Brentwood Professional Group, P.C.
By:   AMERICAN ADDICTION CENTERS, INC., its sole member      
By:  

/s/ Michael T. Cartwright

    By:  

/s/ Mark A. Calarco, D.O.

Name:   Michael T. Cartwright     Name:   Mark A. Calarco, D.O.
Title:   Chairman and Chief Executive Officer     Title:   President and Secretary

 

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Schedule 2.1

Practice’s Services

Professional Services

During the term of this Agreement, Practice, through its physician shareholder, employees and independent contractors (the “ Medical Providers ”), shall provide professional medical services to the patients of Company (the “ Patients ”). Medical Providers may include doctors of medicine, doctors of osteopathy and mid-level providers including physician assistants and advanced practice nurses. Practice shall effectively provide all the professional medical services as required by Company for the needs of its Patients. Such professional medical services shall include those service obligations set forth herein and other related services reasonably requested by Company.

Medical Director Services

During the term of this Agreement, in addition to the professional services described above, Practice shall, unless otherwise agreed to by the parties, provide a physician who is acceptable to Company, to serve as medical director of Facility (the “ Medical Director ”) and provide medical management and oversight for matters specific to Facility pursuant to a medical director agreement between Practice and Medical Director reasonably acceptable to Company (the “ Medical Director Agreement ”). Practice shall cause Medical Director to furnish those services as set forth in the Medical Director Agreement, in accordance with the terms thereof. Upon request, Practice shall provide Company with documentation reasonably acceptable to Company supporting Medical Director’s fulfillment of such duties with Company also retaining the right to conduct such audits thereof as Company determines reasonably necessary to support Company’s payment for such services under this Agreement.

Practice shall provide support, assistance, and work cooperatively with Medical Director who will provide medical management and oversight for Facility. Practice, at the request of Company, shall immediately remove a Medical Director from Facility for cause, as “cause” is defined in Section 2.3.8 hereof.

The term “Medical Provider” as used in this Agreement shall include the Medical Director, provided that any provision that relates specifically to professional medical services will not apply to the Medical Director to the extent that the Medical Director is providing only administrative and not professional services.


Schedule 3.1

Compensation

Practice acknowledges that Practice may sometimes bill separately for the services of Medical Providers, and at other times Company submits global bills for the services of both the Facility and the Medical Providers. In light of the foregoing, Company shall pay to Practice the fees set forth below for services provided by the Medical Providers at the Facility to the extent that such provider services are not separately billed by Practice. To the extent Practice bills separately for Medical Provider services, Company shall not be obligated to pay a fee for such services.

 

Provider

   Fee

Physician/Psychologist Clinical Services

   $125 - $175 per hour*

Medical Director Services

   $100 - $150 per hour*

Mid-level Provider Services (PA or NP)

   $55 - $95 per hour*

 

* Specific hourly rate within the noted range shall be determined by Company in its reasonable discretion after consultation with Practice, based on the experience level, specialty, certifications, and other qualifications of the applicable practitioner.

If Practice is asked by Company to provide additional practitioner services at the Facility, Company shall pay to Practice a fee for such services equal to the rate that Practice pays such provider for the services (unless the service is separately billable by Practice). Practice represents and warrants that the compensation it pays to Medical Providers, and the corresponding fees paid by Company, shall be reasonable and consistent with fair market value. Compensation shall be paid pursuant to Company’s standard payment policies and timing.


Schedule 7.2

HIPAA Business Associate Addendum

This HIPAA Business Associate Addendum (“ Addendum ”) amends and is made part of that certain Professional Services Agreement for Medical Staffing (“ Service Agreement ”), by and between FitRx, LLC (“ Entity ”) and Brentwood Professional Group, P.C. (“ Associate ”) to the extent that Associate is acting as a Business Associate of Entity.

Entity and Associate agree that the parties incorporate this Addendum into the Service Agreement in order to comply with the requirements of: the Health Insurance Portability and Accountability Act of 1996 (“ HIPAA ”), the Health Information Technology for Economic and Clinical Health Act (“ HITECH ”) and their implementing regulations set forth at 45 C.F.R. Parts 160 and Part 164 (the “ HIPAA Rules ”); and Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2 (“ Part 2 Regulations ”). To the extent Associate is acting as a Business Associate of Entity pursuant to the Service Agreement, the provisions of this Addendum shall apply, and Associate shall be subject to the penalty provisions of HIPAA as specified in 45 C.F.R. Part 160.

1. Definitions . Capitalized terms not otherwise defined in this Addendum shall have the meaning set forth in the HIPAA Rules. References to “PHI” mean Protected Health Information maintained, created, received or transmitted by Associate from Entity or on Entity’s behalf.

2. Uses or Disclosures . Associate will neither use nor disclose PHI except as permitted or required by this Addendum or as Required By Law. To the extent Associate is to carry out an obligation of Entity under the HIPAA Rules, Associate shall comply with the requirements of the HIPAA Rules that apply to Entity in the performance of such obligation. Without limiting the foregoing, Associate will not sell PHI or use or disclose PHI for purposes of marketing or fundraising, as defined and proscribed in the HIPAA Rules. Associate is permitted to use and disclose PHI:

(a) to perform any and all obligations of Associate as described in the Service Agreement, provided that such use or disclosure is consistent with the terms of Entity’s notice of privacy practices and would not violate the HIPAA Rules or the Part 2 Regulations, if done by Entity directly;

(b) to perform Data Aggregation services relating to the health care operations of Entity, provided that such services are part of Associate’s obligations as set forth in the Service Agreement;

(c) to create de-identified information in accordance with 45 C.F.R. § 164.514(b), provided that such de-identified information may be used and disclosed only consistent with applicable law; and

(d) as necessary for Associate’s proper management and administration and to carry out Associate’s legal responsibilities (collectively “ Associate’s Operations ”) provided that: any disclosure made for purposes of Associate’s Operations is Required By Law or is made after


Associate obtains reasonable assurances, evidenced by a written contract, from the recipient that the recipient: (i) will hold such PHI in confidence and use or further disclose it only for the purpose for which Associate disclosed it to the recipient or as Required By Law; (ii) will notify Associate of any instance of which the recipient becomes aware in which the confidentiality of such PHI was breached; (iii) acknowledges in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations; and (iv) agrees to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations. Associate shall promptly notify Entity of any disclosures made for purposes of Associate’s Operations.

In the event Entity notifies Associate of a restriction request that would restrict a use or disclosure otherwise permitted by this Addendum, Associate shall comply with the terms of the restriction request.

3. Safeguards . Associate will use appropriate administrative, technical and physical safeguards to prevent the use or disclosure of PHI other than as permitted by this Addendum and shall maintain policies and procedures to detect, prevent, and mitigate identity theft based on PHI or information derived from PHI. Associate will also comply with the provisions of 45 C.F.R. Part 164, Subpart C of the HIPAA Rules with respect to electronic PHI to prevent any use or disclosure of such information other than as provided by this Addendum, which obligation shall include maintaining safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI.

4. Policies and Training . Associate has policies in place regarding the confidential and secure treatment of PHI in accordance with HIPAA and the Part 2 Regulations. Associate shall require its employees to adhere to such policies and shall train its employees regarding the requirements of this Addendum and applicable confidentiality and security laws and regulations.

5. Subcontractors . In accordance with 45 C.F.R. § 164.308(b)(2) and 164.502(e)(1)(ii), Associate will ensure that all of its subcontractors that create, receive, maintain or transmit PHI on behalf of Associate agree by written contract to comply with the same restrictions and conditions that apply to Associate with respect to such PHI, including but not limited to (i) the obligation to safeguard PHI and comply with 45 C.F.R. Part 164, Subpart C; and (ii) acknowledging in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations, and must agree to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations.

6. Minimum Necessary . Associate represents that the PHI requested, used or disclosed by Associate shall be the minimum amount necessary to carry out the purposes of the Service Agreement. Associate will limit its uses and disclosures of, and requests for, PHI to the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request.

7. Obligations of Entity . Entity shall notify Associate of (i) any limitations in its notice of privacy practices, (ii) any changes in, or revocation of, permission by an individual to use or disclose PHI, and (iii) any confidential communication request or restriction on the use or disclosure of PHI that Entity has agreed to or with which Entity is required to comply, to the extent any of the foregoing affect Associate’s use or disclosure of PHI to perform its obligations as described in the Service Agreement.


8. Access and Amendment . In accordance with 45 C.F.R. § 164.524, Associate will permit Entity or, at Entity’s request, an individual (or the individual’s designee) to inspect and obtain copies of any PHI about the individual that is in Associate’s custody or control and that is maintained in a Designated Record Set. If the requested PHI is maintained electronically, Associate must provide a copy of the PHI in the electronic form and format requested by the individual, if it is readily producible, or, if not, in a readable electronic form and format as agreed to by Entity and the individual. Associate will notify Entity of any request (including but not limited to subpoenas) that Associate receives for access to PHI that is in Associate’s custody or control within five (5) business days of receipt of such request. Entity shall be responsible for making determinations about access. Associate will, upon receipt of notice from Entity, promptly amend or permit Entity access to amend any portion of the PHI that is in Associate’s custody or control so that Entity may meet its amendment obligations under 45 C.F.R. § 164.526.

9. Disclosure Accounting . Except for disclosures excluded from the accounting obligation by the HIPAA Rules and regulations issued pursuant to HITECH, Associate will record for each disclosure that Associate makes of PHI the information necessary for Entity to make an accounting of disclosures pursuant to the HIPAA Rules. In the event the U.S. Department of Health and Human Services (“ HHS ”) finalizes regulations requiring Covered Entities to provide access reports, Associate shall also record such information with respect to electronic PHI held by Associate as would be required under the regulations for Covered Entities beginning on the effective date applicable to Entity. Associate will make information required by this Section 9 available to Entity promptly upon Entity’s request for the period requested, but for no longer than the six (6) years preceding Entity’s request for the information or such other period required by the HIPAA Rules (except Associate need not have any information for disclosures occurring before the effective date of any previous HIPAA business associate agreements between the parties or, if none, the effective date of this Addendum).

10. Inspection of Books and Records . Associate will make its internal practices, books, and records, relating to its use and disclosure of PHI available upon request to Entity or HHS to determine Entity’s compliance with the HIPAA Rules.

11. Reporting . To the extent Associate becomes aware or discovers any use or disclosure of PHI not permitted by this Addendum, any Security Incident involving electronic PHI, any Breach of Unsecured Protected Health Information or any Red Flag (as defined at 16 C.F.R. § 681.2(b)) related to any individual who is the subject of PHI, Associate shall promptly report such use, disclosure, Security Incident, Breach or Red Flag to Entity. Associate shall mitigate, to the extent practicable, any harmful effect known to it of a Security Incident, Breach or use or disclosure of PHI by Associate not permitted by this Addendum. Notwithstanding the foregoing, the parties acknowledge and agree that this Section 11 constitutes notice by Associate to Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents (as defined below) for which no additional notice to Entity shall be required. “Unsuccessful Security Incidents” shall include, but not be limited to, pings and other broadcast attacks on Associate’s firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or


disclosure of electronic PHI. All reports of Breaches shall be made within ten (10) business days of Associate discovering the Breach and shall comply with and include the information specified at 45 C.F.R. § 164.410. Associate shall promptly reimburse Entity all reasonable costs incurred by Entity with respect to providing notification of and mitigating a Breach involving Associate, including but not limited to printing, postage costs and toll-free hotline costs.

12. Confidentiality of Alcohol and Drug Abuse Patient Records . Associate: (1) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from Entity about individuals who are patients of Entity (“ Patients ”), it is fully bound by the provisions of the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2; and (2) undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to Patients otherwise than as expressly provided for in the Part 2 Regulations.

13. Term and Termination . This Addendum shall be effective as of the effective date of the Service Agreement and shall remain in effect until termination of the Service Agreement. Either party may terminate this Addendum and the Service Agreement effective immediately if it determines that the other party has breached a material provision of this Addendum and failed to cure such breach within thirty (30) days of being notified by the other party of the breach. If the non-breaching party determines that cure is not possible, such party may terminate this Addendum and the Service Agreement effective immediately upon written notice to other party.

Upon termination of this Addendum for any reason, Associate will, if feasible, return to Entity or securely destroy all PHI maintained by Associate in any form or medium, including all copies of such PHI, at no cost to Entity. Further, Associate shall recover any PHI in the possession of its agents and subcontractors and return to Entity or securely destroy all such PHI. Notwithstanding the foregoing, Associate shall notify Entity and receive Entity’s written consent prior to destroying any PHI of which Entity does not maintain a duplicate copy. In the event that Associate determines that returning or destroying any PHI is infeasible, Associate shall promptly notify Entity of the conditions that make return or destruction infeasible. With regard to any PHI that Entity agrees cannot feasibly be returned to Entity or destroyed, Associate may maintain such PHI but shall continue to abide by the terms and conditions of this Addendum with respect to such PHI and shall limit its further use or disclosure of such PHI to those purposes that make return or destruction of the PHI infeasible. Associate shall comply with this Section 13 within thirty (30) days of termination of this Addendum. Associate shall provide Entity with written certification of its compliance with this Section 13 within forty-five (45) days of termination of this Addendum. Upon termination of this Addendum for any reason, all of Associate’s obligations under this Addendum shall survive termination and remain in effect (a) until Associate has completed the return or destruction of PHI as required by this Section 13 and (b) to the extent Associate retains any PHI pursuant to this Section 13 .

14. General Provisions . In the event that any final regulation or amendment to final regulations is promulgated by HHS or other government regulatory authority with respect to PHI, this Addendum will automatically be amended to remain in compliance with such regulations, and Associate shall promptly amend its contracts, if any, with subcontractors and agents to conform to the terms of this Addendum. Any ambiguity in this Addendum shall be resolved to permit Entity to comply with the HIPAA Rules and the Part 2 Regulations. Nothing


in this Addendum shall be construed to create any rights or remedies in any third parties or any agency relationship between the parties. A reference in this Addendum to a section in the HIPAA Rules or the Part 2 Regulations means the section as in effect or as amended. This Addendum replaces and supersedes and previous business associate agreements between the parties. The terms and conditions of this Addendum override and control any conflicting term or condition of the Service Agreement. To the extent Associate has limited its liability under the terms of the Service Agreement by a maximum recovery for direct damages, disclaimer against any consequential, indirect or punitive damages or any other limitation, all limitations shall exclude any damages to Entity arising from Associate’s breach of its obligations under this Addendum. All non-conflicting terms and conditions of the Service Agreement remain in full force and effect.

Exhibit 10.45

PROFESSIONAL SERVICES AGREEMENT

For Medical Staffing

THIS PROFESSIONAL SERVICES AGREEMENT for Medical Staffing (“ Agreement ”) is made this 5 th day of August, 2014 (the “ Effective Date ”), between Grand Prairie Professional Group, P.A. (“ Practice ), a professional association organized under the laws of Texas, and Greenhouse Treatment Center, LLC d/b/a The Greenhouse, a Texas limited liability company (“ Company ”) (individually, a “ Party ,” and, collectively, the “ Parties ”).

W I TN E S S E T H:

WHEREAS , Company has established and operates an addiction treatment facility, Greenhouse Treatment Center, LLC d/b/a The Greenhouse (“ Facility ”), located at 1171 107 th Street, Grand Prairie, Texas 75050;

WHEREAS , Practice employs Medical Providers and other medical personnel specializing in the treatment of various addictions;

WHEREAS , Practice is owned by a physician licensed to practice medicine in the state of Texas (the “ State ”); and

WHEREAS , Company desires to engage Practice as of the Effective Date to provide, or arrange the provision of, medical services on behalf of Company, and Practice desires to accept such engagement as of the Effective Date, all upon the terms and conditions set forth in this Agreement.

NOW , THEREFORE , for and in consideration of the mutual agreements, covenants, terms and conditions herein contained, the Parties agree as follows:

ARTICLE I

ESTABLISHMENT OF PROFESSIONAL RELATIONSHIP

1.1 Engagement of Practice . As of the Effective Date, Company engages Practice, and Practice accepts said engagement, to provide medical services in accordance with the terms and conditions of this Agreement.

1.2 Relationship of the Parties . In the performance of their respective duties and obligations hereunder, the Parties are independent contractors, and as such they shall remain professionally and economically independent of each other. The Parties are not, and shall not be deemed to be, joint venturers, partners, employees, or agents of each other (except with respect to an agency for billing and collection activities expressly addressed in this Agreement). Neither Party shall have any authority to bind or incur any financial obligations on behalf of the other without the other’s express written consent, and then only insofar as such authority is conferred by such express written consent.


ARTICLE II

PRACTICE’S OBLIGATIONS

2.1 General Obligations . Practice shall provide the Medical Provider services set forth on Schedule 2.1 , attached hereto and incorporated herein by reference.

2.2 Responsibility for Medical Provider Services . Practice shall control and be responsible for the provision of medical services to Patients (as such term is defined on Schedule 2.1 ), and Company shall not engage in the practice of medicine nor shall it intervene or interfere in professional medical judgment of Practice or any Medical Provider; provided , however, that Practice shall cause the Medical Providers to comply with Company’s systems and procedures for review and improvement of the delivery of care.

2.3 Qualifications and Standards . Practice shall take all necessary actions to ensure that each Medical Provider satisfies the following conditions at all times during the Term:

2.3.1 Licensure and Experience Levels . Each Medical Provider shall maintain an unrestricted license to practice his or her specialty in the State and at all times shall be in good standing with the appropriate licensing board. Each Medical Provider shall have a level of competence, experience and skill at least comparable to that prevailing in the community.

2.3.2 Federal DEA Number . The Medical Providers shall maintain a Federal DEA number without restrictions, to the extent necessary for his or her practice.

2.3.3 Medical Standards . Each Medical Provider shall perform all medical services to be provided hereunder in accordance with the current standards of care in the medical community and any credentialing and quality criteria that are adopted from time to time by Company, the Facility and/or Practice

2.3.4 Continuing Education . Medical Providers shall participate in such continuing medical education and training programs as required by law to maintain skills compatible with standards of medical care in the community.

2.3.5 Bylaws . Medical Providers shall comply with any bylaws, policies, rules or regulations of Facility or Company, as may be amended from time to time.

2.3.6 Laws . Medical Providers shall comply with all applicable standards, rulings, regulations and requirements of the United States Department of Health and Human Services, the State’s department of health, the applicable accreditation agency of the Facility, and any federal, state or local government agency, third party payor or accrediting body having jurisdiction over or providing reimbursement for the Facility and any programs and services offered by either the Facility or Company.

2.3.7 Cooperation . Practice shall promptly notify Company if a claim of malpractice or professional discipline is asserted against any Medical Provider resulting from medical services provided at Facility; additionally Practice shall notify Company of claims not yet asserted against Medical Providers, but the potential for which Practice is aware.

 

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2.3.8 Approval and Removal . Each Medical Provider shall be subject to the initial approval of Company before he or she commences providing services at Facility. In addition, Practice, at the request of Company, shall immediately remove a Medical Provider from Facility for cause. For purposes of this Section 2.3.8 , “for cause” shall be determined by Company acting reasonably and in good faith and shall include the following: (a) suspension or revocation or other sanction of his or her medical license, specialty board certification, or Federal Drug Enforcement Agency (“ DEA ”) registration; (b) suspension, revocation, or reduction of his or her status or privileges as a member of the medical staff of any hospital utilized by Company for Patients served by the Medical Providers (including without limitation any resignation of membership or privileges in lieu of or to avoid any of the foregoing actions); (c) being arrested or indicted for, or convicted of any felony or any criminal charge relating to the practice of medicine; (d) being found by the appropriate licensure board or other state or federal regulatory agency to have violated any provision of law or the applicable code of medical ethics; (e) cancellation, termination or non-renewal of his or her professional liability insurance and failure to obtain replacement coverage within thirty (30) days; or (f) having committed any actions or inactions which pose an immediate and significant threat to Patients.

2.4 Compensation Responsibility . Practice shall be solely responsible for establishing and paying the compensation and fringe benefits, if any, to the Medical Providers. Practice shall be solely responsible for the payment and withholding of appropriate amounts for income tax, social security, unemployment insurance, and state disability insurance taxes. Practice shall also maintain in full force and effect all worker’s compensation insurance as may be required under the worker’s compensation laws of the State.

2.5 Medical Provider Staffing Levels . As of the Effective Date, Practice shall assign to Facility Medical Providers necessary to satisfy the patient needs at the Facility.

2.6 Authority . Practice has the right to enter into this Agreement, and neither the execution of this Agreement nor Practice’s performance hereunder will result in it being in breach or default of any existing agreement.

ARTICLE III

COMPENSATION

3.1 General Compensation Principles . Practice shall be compensated for the services provided hereunder pursuant to the terms of this Agreement as described in Schedule 3.1 , which is attached hereto and incorporated herein by reference. The Parties hereby acknowledge and agree that such amount represents the fair market value of the services provided hereunder.

ARTICLE IV

PATIENT CHARGES, BILLING AND COLLECTION

4.1 Billing; Assignment of Fees . Company, directly or through an affiliate, shall bill payors and patients for all technical and facility fees of the Facility. In addition, to the extent permissible by applicable law and third party payor policies, Company may (directly or through

 

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an affiliate) bill payors and patients globally for Company’s services and also the professional services of Practice and the Medical Providers that are provided pursuant to this Agreement. Practice authorizes Company, directly or through an affiliate, to bill and collect all professional fees of Practice and the Medical Providers, as Practice’s and the Medical Providers’ agent and attorney-in-fact to the extent permitted by applicable law for all services rendered by Practice or the Medical Providers at the Facility or on behalf of Company hereunder, either in Company’s own name or in Practice’s or individual Medical Provider’s name and provider number. Practice shall ensure that each Medical Provider executes such documentation as may be necessary to permit such billing by Company. To the extent that it is not allowable by law or payor policies for Company to bill for services on behalf of Practice or Medical Providers, Practice will bill in its own name for such services, provided that Practice intends to engage American Addiction Centers, Inc., an affiliate of Company, to provide billing support services. Practice shall ensure that duplicative billing does not occur, and neither it nor any Medical Provider will payors or patients for the same services that are billed by Company.

4.2 Practice to Provide Billing Information . For all applicable services described in Section 4.1 above and in accordance with applicable law, Practice shall provide Company with all billing information for services rendered by the Medical Providers, including, but not limited to, the name of the Patient, the date of service, the nature and extent of services provided, Patient diagnosis, and any supporting medical and non-medical information necessary to bill such services and to obtain payment and/or reimbursement. Each Medical Provider shall provide the above-described billing information to Company within seven (7) calendar days after the applicable medical services are rendered. The applicable treating Medical Provider shall be responsible for appropriately coding the service provided and supplying the correct CPT, KEY, ICD-9 (or ICD-10 once applicable) or other codes associated with the service.

ARTICLE V

INSURANCE

5.1 Comprehensive General Liability and Property Insurance . Company shall procure and maintain during the Term of this Agreement comprehensive general liability insurance covering its activities relating to Facility and property insurance covering the Facility. The comprehensive general liability insurance maintained hereunder shall be in amounts deemed sufficient by Company to protect against risks and losses associated with the operations of Facility.

5.2 Company’s Professional Liability Insurance . Company shall procure and maintain in full force and effect during the Term of this Agreement professional liability insurance covering Company and appropriate personnel provided by Company pursuant to this Agreement, including, without limitation, Company’s provider employees and contractors (subject to prior approval of insurer), against errors and omissions arising from Patient services and/or non-medical services rendered by Company pursuant to this Agreement. All premiums, costs and expenses associated with such professional liability insurance shall be borne by and paid by Company. The professional liability insurance procured by Company shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate. For purposes of Sections 5.1 and 5.2 , the term “insurance” shall include self-insurance arrangements maintained by Company for itself and its corporate affiliates, including Facility.

 

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5.3 Practice’s Professional Liability Insurance . Practice shall procure and maintain in full force and effect during the Term of this Agreement, and for a period of three (3) years subsequent to the expiration or earlier termination of this Agreement, professional liability insurance (i.e., medical malpractice insurance) with an insurer acceptable to Company, protecting Practice and its shareholders, officers, directors, and the Medical Providers against errors and omissions arising from professional services and/or medical services rendered by Practice and the Medical Providers. Such policy of insurance shall name Company as an additional insured. The insurance required by this Section 5.3 shall specifically extend to acts or omissions of Medical Providers occurring both prior and subsequent to the Effective Date. All premiums, costs and expenses associated with such professional liability insurance shall be borne by Practice. The professional liability insurance required by this Section 5.3 shall have limits of liability of at least one million dollars ($1,000,000) per claim and three million dollars ($3,000,000) per annual aggregate.

5.4 Proof of Insurance . At the request of the other Party, each Party shall furnish copies of or Certificates of Insurance on all policies required under this Article V (or evidence of self-insurance) as evidence of the insurance coverage to be procured pursuant to this Agreement. In the case of Company, this evidence shall also specifically include evidence of “tail” or other coverage for acts and omissions occurring prior to the Effective Date. The insurance coverage required under this Agreement shall not be canceled, modified, reduced or otherwise materially changed, except upon thirty (30) days’ prior written notice to the non-procuring Party.

ARTICLE VI

INDEMNIFICATION

6.1 Indemnification by Company . Company shall indemnify, defend and hold Practice, and the shareholders, directors, officers and employees of Practice, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs, and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly from any negligent or willful act or omission of Company or its non-Medical Provider employees providing services at Facility. Notwithstanding any provisions of the preceding sentence to the contrary, Company shall not be liable to Practice for any consequential, exemplary or punitive damages. The duty of Company to indemnify, defend and hold harmless Practice shall only apply to the extent that any such loss sustained by Practice is not covered by insurance. The indemnification provisions of this Section 6.1 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other.

6.2 Indemnification by Practice . Practice shall indemnify, defend and hold Company, and the shareholders, directors, officers and employees of Company, free and harmless from and against any and all claims, demands, liabilities, losses, damages, costs and expenses, including reasonable attorneys’ fees, resulting in any manner, directly or indirectly, from any negligent or willful act or omission of any Medical Provider, including, specifically, (i) negligent or willful acts occurring both prior to and subsequent to the Effective Date and (ii)

 

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claims against Company attributable directly or indirectly to incorrect billing information provided to Company by Practice or any Medical Provider. Notwithstanding any provisions of the preceding sentence to the contrary, Practice shall not be liable to Company for any consequential, exemplary or punitive damages. The indemnification provisions of this Section 6.2 are intended to be in addition to any common law rights to contribution existing under the laws of the State which one Party may have against the other. A provision similar to that set forth in this Section 6.2 shall be contained in each contract between Practice and any independent contractor providing professional medical services for Practice at the Facility in order to ensure that each such Medical Provider has agreed to indemnify Company as required by this Section 6.2 .

ARTICLE VII

RECORDS AND CONFIDENTIALITY

7.1 Ownership of Records and Files . All business or medical records and files of whatever nature or kind, including Patients’ files and x-rays, are the property of Company to the extent permitted by law; neither Practice nor individual Medical Providers shall acquire any proprietary rights with respect to such records. However, at Practice’s written request, Company shall provide Medical Providers with copies of any records reflecting services performed by such Medical Provider with respect to (a) any claims against him/her in the nature of malpractice, (b) any charges against him/her issued by a licensing board or professional association or (c) for any other purpose deemed appropriate by Company

7.2 Confidentiality of Medical Records . Both Parties shall comply with all applicable federal and state laws and regulations regarding the confidential and secure treatment of individually identifiable health information, including 42 C.F.R. Part 2, and with the terms of the Business Associate Addendum attached as Schedule 7.2 hereto and incorporated herein by reference.

7.3 Medical Records upon Termination . Upon the expiration or earlier termination of this Agreement, unless a Patient specifies otherwise and in accordance with applicable law, Company shall be entitled to the original medical records for all Patients, and Practice shall be entitled to copy such records, with the cost of any copies to be home by Practice. For such period as is required by applicable statutes, Company shall keep possession of the original medical records and shall retain the records in their original condition, shall store the records in a safe place and make the records available to Practice without charge if reasonably necessary for any purpose, including, without limitation, Patient care and medical malpractice defense.

ARTICLE VIII

TERM AND TERMINATION

8.1 Term . This Agreement shall be effective for a term of five (5) years, beginning on the Effective Date, unless terminated pursuant to the provisions of this Article VIII (the “ Initial Term ”). Upon expiration of the Initial Term, this Agreement will automatically renew for additional one (1) year terms (the “ Renewal Terms ”) unless either Party shall provide notice to the other Party of its intent to terminate the Agreement under the terms of this Section 8.1

 

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(“ Notice of Intent to Terminate ”). Notice of Intent to Terminate must be provided no later than one (1) year prior to the expiration of the Initial Term, and no later than ninety (90) days prior to the expiration of any Renewal Term.

8.2 Termination upon Insolvency . If either Party shall apply for or consent to the appointment of a receiver, trustee or liquidation of itself, or if all or a substantial part of its assets, file a voluntary petition in bankruptcy or admit in writing its inability to pay its debts as they become due, make a general assignment for the benefit of creditors, file a petition or an answer seeking reorganization or arrangement with creditors, or take advantage of any insolvency law, or if an order, judgment, or decree shall be entered by a court of competent jurisdiction or an application of a creditor, adjudicating such party to be bankrupt or insolvent, or approving a petition seeking reorganization of such Party or appointing a receiver, trustee or liquidator of such Party or of all or a substantial part of its assets, and such order, judgment, or decree shall continue in effect and unstayed for a period of thirty (30) consecutive days, then the other Party may terminate this Agreement upon ten (10) days prior written notice to such Party.

8.3 Termination upon Legal Prohibitions of Relationship . If counsel jointly selected by the Parties should determine (the “ Determination ”) that it is more likely than not that applicable legislation, regulations, rules or procedures (collectively referred to herein as a “ Law ”) in effect or to become effective as of a date certain, or if Practice or Company receives notice (the “ Notice ”) of an actual or threatened decision, finding or action by any governmental or private agency or court (collectively referred to herein as an “ Action ”), which Law or Action, if or when implemented, would have the effect of subjecting either Party to civil or criminal prosecution under state and/or federal Laws, or other adverse proceeding on the basis of their participation herein, then the Parties shall attempt in good faith to amend this Agreement to the extent necessary in order to comply with such Law or to avoid the Action, as applicable. If, within ninety (90) days of providing written notice of such Determination or Notice to the other Party, the Parties acting in good faith are unable to mutually agree upon and make amendments or alterations to this Agreement to meet the requirements in question, or alternatively, the Parties mutually determine in good faith that compliance with such requirements is impossible or unfeasible, then this Agreement shall be terminated without penalty, charge or continuing liability upon the earlier of the following: the date one hundred eighty (180) days subsequent to the date upon which either Party gives written notice to the other Party or the effective date on which the Law or Action prohibits the relationship of the Parties pursuant to this Agreement.

8.4 Termination upon Breach . Either Party may elect to terminate this Agreement in the event that the other Party is in material breach of this Agreement and such default continues for a period of fifteen (15) calendar days after written notice thereof has been given to the Party in default by the other Party; provided , however, that Company may immediately terminate this Agreement if Practice fails to provide, or arrange the provision of, adequate professional medical services pursuant to this Agreement for a period of three (3) calendar days.

8.5 Termination Without Cause . This Agreement shall automatically terminate upon one hundred and eighty (180) days’ notice by either Party to the other Party.

8.6 Termination and Liabilities . In the event either Party validly elects to terminate this Agreement pursuant to the provisions of this Article VIII or the Agreement expires by its

 

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own terms, the liabilities and obligations of the Parties shall cease as of the date of termination, except that each Party shall be responsible for: (a) any payments or other obligations arising or accruing prior to the termination date and (b) any breach arising after termination or expiration with respect to obligations that continue after such expiration or termination. Neither Party shall be liable to the other for any damages resulting from any event of force majeure. The Parties agree that upon such termination, they will mutually work to assure an orderly transition of services.

ARTICLE IX

GENERAL PROVISIONS

9.1 Independence of Medical Judgment . Nothing in this Agreement shall affect the exercise of Medical Providers’ independent medical judgment.

9.2 Entire Agreement; Amendment . This Agreement constitutes the entire agreement between the Parties pertaining to the subject matter contained herein and supersedes all prior and contemporaneous agreements, representations and understandings of the Parties which relate to the subject matter of this Agreement. No supplement, amendment or modification of this Agreement shall be binding unless executed in writing by the Parties, unless otherwise provided herein.

9.3 No Waiver . No waiver of any of the provisions of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the Party making the waiver.

9.4 Subject Headings . The subject headings of the Articles and Sections of this Agreement are included for purposes of convenience only, and shall not affect the construction or interpretation of any of the provisions of this Agreement.

9.5 Binding Agreement; No Assignment . This Agreement shall be binding upon, and shall inure to the benefit of, the Parties and their respective legal representatives, successors and assigns. Company may assign this Agreement upon prior written notice to Practice. Practice may not assign this Agreement nor any rights hereunder, nor may it delegate any of the duties to be performed hereunder without the prior written consent of Company; provided , however, that notwithstanding the foregoing sentence to the contrary, Practice shall have the right to assign this Agreement to another corporate affiliate of Company upon written notice and shall have the right to subcontract with any other responsible parties, including specifically, corporate affiliates of Practice, for the performance of various aspects of its obligations hereunder, provided that Practice shall remain fully responsible for the performance of any such subcontractors.

9.6 Severability . Except as otherwise provided in Section 8.3 , in the event any provision of this Agreement is rendered invalid or unenforceable by the enactment of any applicable statute or ordinance or by any regulation duly promulgated or is made or declared unenforceable by any court of competent jurisdiction, the remainder of this Agreement shall remain in full force and effect.

 

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9.7 Attorneys’ Fees . In the event any attorney is employed by any Party with regard to any legal action, arbitration or other proceeding brought by any Party for the enforcement of this Agreement, or because of an alleged dispute, breach, default or misrepresentation in connection with any of the provisions of this Agreement, then the prevailing Party, whether at trial or upon appeal, and in addition to any other relief to which the prevailing Party may be granted, shall be entitled to recover from the losing Party all costs, expenses and attorneys’ fees incurred by the prevailing Party in bringing or defending such action, arbitration or proceeding, and in enforcing any judgment granted therein, all of which costs, expenses and attorneys’ fees shall be deemed to have accrued upon the commencement of such action and shall be paid whether or not such action is prosecuted to judgment. Any judgment or order entered in such matter shall contain a specific provision providing for the recovery by the prevailing Party of attorneys’ fees, costs and expenses incurred in enforcing such judgment. For purposes of this Section 9.7 , attorneys’ fees shall include, without limitation, fees incurred in the following: post-judgment motions; contempt proceedings; garnishment, levy and debtor and third party examinations; discovery; and bankruptcy litigation.

9.8 Notices . All notices, requests, demands or other communications under this Agreement shall be in writing and shall be deemed to have been duly given on the date of service if served personally on the Party to whom notice is to be given, or on the third day after mailing if mailed to the Party to whom notice is to be given, by a recognized overnight carrier service, or by first class mail, registered or certified, postage prepaid, and properly addressed as follows:

 

TO PRACTICE:    Grand Prairie Professional Group, P.A.
   1171 107 th Street, Suite A
   Grand Prairie, Texas 75050
   Attn: Mark A. Calarco, D.O.
TO COMPANY:    Greenhouse Treatment Center, LLC d//b/a The Greenhouse
   1171 107 th Street
   Grand Prairie, Texas 75050
   Attn.: Chief Executive Officer
WITH COPY TO:   
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Candance A. Henderson-Grice, Chief Operating Officer
   Email: chenderson-grice@contactaac.com
   American Addiction Centers, Inc.
   115 East Park Drive, Second Floor
   Brentwood, Tennessee 37027
   Attn: Kathryn Sevier Phillips, General Counsel and Secretary
   Fax: (615) 691-7130
   Email: ksphillips@contactaac.com

 

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Each Party may change its address indicated above by giving the other Party written notice of the new address in the manner set forth above.

9.9 Governing Law . This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State. All actions, suits, or other proceedings with respect to this Agreement shall be brought only in a court of competent jurisdiction in the State. In any such action, suit, or proceeding, such court shall have personal jurisdiction over all of the parties hereto, and service of process upon them under any applicable statutes, laws, and rules shall be deemed valid and good.

9.10 Third Party Rights . This Agreement is entered into by and between the Parties hereto for their sole benefit. There is no intent by either Party to create or establish third party beneficiary status or rights in any third party to this Agreement and no third party shall have any right to enforce any right or enjoy any benefit created or established by this Agreement.

9.11 No Discrimination . No person shall be excluded from participation in, or be denied benefits of, or be otherwise subjected to discrimination in the performance of this Agreement or any Addenda on the grounds of disability, age, race, color, religion, sex, national origin or any other classification protected by federal and/or Tennessee constitutional, statutory and/or regulatory provisions.

9.12 Signatory . Each Party warrants that the person indicated on signatory line to this Agreement has all authority necessary to bind the Party and is the appropriate designated person to sign this Agreement.

9.13 Counterparts . This Agreement may be signed in multiple counterparts, each of which shall be deemed to be an original and all of which taken together shall constitute a single instrument.

9.14 Drafted Jointly . In the event of an ambiguity or question of intent or interpretation arises, this Agreement shall be construed as if drafted jointly by the Parties, and no presumption or burden of proof shall arise favoring or disfavoring any Party by virtue of authorship of the provisions of this Agreement.

9.15 Cooperation . The Parties agree to cooperate with each other to resolve promptly any outstanding financial, administrative or patient care issues upon the termination of this Agreement. Such obligation shall include, without limitation, the provision of patient, resident and/or administrative records, payments or other actions necessary to conclude the relationship of the Parties. This Section 9.15 shall survive the termination of this Agreement for any reason. Each Party further agrees to cooperate with the other to carry out the purpose and intent of this Agreement, including without limitation the execution and delivery to the appropriate Party of any further agreements and other documents and the taking of any action as may reasonably be required to effectuate the provisions of this Agreement.

[Signature Page Follows]

 

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IN WITNESS WHEREOF , the Parties hereto have duly executed this Agreement on the dates set forth below, provided that this Agreement is effective as of the Effective Date.

 

For Company:     For Practice:
Greenhouse Treatment Center, LLC     Grand Prairie Professional Group, P.A.
d/b/a The Greenhouse    
By:  

/s/ Michael T. Cartwright

    By:  

/s/ Mark A. Calarco, D.O.

Name:   Michael T. Cartwright     Name:   Mark A. Calarco, D.O.
Title:   Manager     Title:   President, Secretary and Treasurer

 

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Schedule 2.1

Practice’s Services

Professional Services

During the term of this Agreement, Practice, through its physician shareholder, employees and independent contractors (the “ Medical Providers ”), shall provide professional medical services to the patients of Company (the “ Patients ”). Medical Providers may include doctors of medicine, doctors of osteopathy and mid-level providers including physician assistants and advanced practice nurses. Practice shall effectively provide all the professional medical services as required by Company for the needs of its Patients. Such professional medical services shall include those service obligations set forth herein and other related services reasonably requested by Company.

Medical Director Services

During the term of this Agreement, in addition to the professional services described above, Practice shall, unless otherwise agreed to by the parties, provide a physician who is acceptable to Company, to serve as medical director of Facility (the “ Medical Director ”) and provide medical management and oversight for matters specific to Facility pursuant to a medical director agreement between Practice and Medical Director reasonably acceptable to Company (the “ Medical Director Agreement ”). Practice shall cause Medical Director to furnish those services as set forth in the Medical Director Agreement, in accordance with the terms thereof. Upon request, Practice shall provide Company with documentation reasonably acceptable to Company supporting Medical Director’s fulfillment of such duties with Company also retaining the right to conduct such audits thereof as Company determines reasonably necessary to support Company’s payment for such services under this Agreement.

Practice shall provide support, assistance, and work cooperatively with Medical Director who will provide medical management and oversight for Facility. Practice, at the request of Company, shall immediately remove a Medical Director from Facility for cause, as “cause” is defined in Section 2.3.8 hereof.

The term “Medical Provider” as used in this Agreement shall include the Medical Director, provided that any provision that relates specifically to professional medical services will not apply to the Medical Director to the extent that the Medical Director is providing only administrative and not professional services.


Schedule 3.1

Compensation

Practice acknowledges that Practice may sometimes bill separately for the services of Medical Providers, and at other times Company submits global bills for the services of both the Facility and the Medical Providers. In light of the foregoing, Company shall pay to Practice the fees set forth below for services provided by the Medical Providers at the Facility to the extent that such provider services are not separately billed by Practice. To the extent Practice bills separately for Medical Provider services, Company shall not be obligated to pay a fee for such services.

 

Provider

   Fee

Physician/Psychologist Clinical Services

   $125 - $ 175 per hour*

Medical Director Services

   $ 100 - $ 150 per hour*

Mid-level Provider Services (PA or NP)

   $ 55 - $ 95 per hour*

 

* Specific hourly rate within the noted range shall be determined by Company in its reasonable discretion after consultation with Practice, based on the experience level, specialty, certifications, and other qualifications of the applicable practitioner.

If Practice is asked by Company to provide additional practitioner services at the Facility, Company shall pay to Practice a fee for such services equal to the rate that Practice pays such provider for the services (unless the service is separately billable by Practice). Practice represents and warrants that the compensation it pays to Medical Providers, and the corresponding fees paid by Company, shall be reasonable and consistent with fair market value. Compensation shall be paid pursuant to Company’s standard payment policies and timing.


Schedule 7.2

HIPAA Business Associate Addendum

This HIPAA Business Associate Addendum (“ Addendum ”) amends and is made part of that certain Professional Services Agreement for Medical Staffing (“ Service Agreement ”), by and between Greenhouse Treatment Center, LLC d/b/a The Greenhouse (“ Entity ”) and Grand Prairie Professional Group, P.A. (“ Associate ”) to the extent that Associate is acting as a Business Associate of Entity.

Entity and Associate agree that the parties incorporate this Addendum into the Service Agreement in order to comply with the requirements of: the Health Insurance Portability and Accountability Act of 1996 (“ HIPAA ”), the Health Information Technology for Economic and Clinical Health Act (“ HITECH ”) and their implementing regulations set forth at 45 C.F.R. Parts 160 and Part 164 (the “ HIPAA Rules ”); and Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2 (“ Part 2 Regulations ”). To the extent Associate is acting as a Business Associate of Entity pursuant to the Service Agreement, the provisions of this Addendum shall apply, and Associate shall be subject to the penalty provisions of HIPAA as specified in 45 C.F.R. Part 160.

1. Definitions . Capitalized terms not otherwise defined in this Addendum shall have the meaning set forth in the HIPAA Rules. References to “PHI” mean Protected Health Information maintained, created, received or transmitted by Associate from Entity or on Entity’s behalf.

2. Uses or Disclosures . Associate will neither use nor disclose PHI except as permitted or required by this Addendum or as Required By Law. To the extent Associate is to carry out an obligation of Entity under the HIPAA Rules, Associate shall comply with the requirements of the HIPAA Rules that apply to Entity in the performance of such obligation. Without limiting the foregoing, Associate will not sell PHI or use or disclose PHI for purposes of marketing or fundraising, as defined and proscribed in the HIPAA Rules. Associate is permitted to use and disclose PHI:

(a) to perform any and all obligations of Associate as described in the Service Agreement, provided that such use or disclosure is consistent with the terms of Entity’s notice of privacy practices and would not violate the HIPAA Rules or the Part 2 Regulations, if done by Entity directly;

(b) to perform Data Aggregation services relating to the health care operations of Entity, provided that such services are part of Associate’s obligations as set forth in the Service Agreement;

(c) to create de-identified information in accordance with 45 C.F.R. § 164.514(b), provided that such de-identified information may be used and disclosed only consistent with applicable law; and

(d) as necessary for Associate’s proper management and administration and to carry out Associate’s legal responsibilities (collectively “ Associate’s Operations ”) provided that: any


disclosure made for purposes of Associate’s Operations is Required By Law or is made after Associate obtains reasonable assurances, evidenced by a written contract, from the recipient that the recipient: (i) will hold such PHI in confidence and use or further disclose it only for the purpose for which Associate disclosed it to the recipient or as Required By Law; (ii) will notify Associate of any instance of which the recipient becomes aware in which the confidentiality of such PHI was breached; (iii) acknowledges in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations; and (iv) agrees to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations. Associate shall promptly notify Entity of any disclosures made for purposes of Associate’s Operations.

In the event Entity notifies Associate of a restriction request that would restrict a use or disclosure otherwise permitted by this Addendum, Associate shall comply with the terms of the restriction request.

3. Safeguards . Associate will use appropriate administrative, technical and physical safeguards to prevent the use or disclosure of PHI other than as permitted by this Addendum and shall maintain policies and procedures to detect, prevent, and mitigate identity theft based on PHI or information derived from PHI. Associate will also comply with the provisions of 45 C.F.R. Part 164, Subpart C of the HIPAA Rules with respect to electronic PHI to prevent any use or disclosure of such information other than as provided by this Addendum, which obligation shall include maintaining safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI.

4. Policies and Training . Associate has policies in place regarding the confidential and secure treatment of PHI in accordance with HIPAA and the Part 2 Regulations. Associate shall require its employees to adhere to such policies and shall train its employees regarding the requirements of this Addendum and applicable confidentiality and security laws and regulations.

5. Subcontractors . In accordance with 45 C.F.R. § 164.308(b)(2) and 164.502(e)(1)(ii), Associate will ensure that all of its subcontractors that create, receive, maintain or transmit PHI on behalf of Associate agree by written contract to comply with the same restrictions and conditions that apply to Associate with respect to such PHI, including but not limited to (i) the obligation to safeguard PHI and comply with 45 C.F.R. Part 164, Subpart C; and (ii) acknowledging in writing that, in receiving PHI, the recipient is fully bound by the Part 2 Regulations, and must agree to, if necessary, resist in judicial proceedings any efforts to obtain access to PHI except as permitted by the Part 2 Regulations.

6. Minimum Necessary . Associate represents that the PHI requested, used or disclosed by Associate shall be the minimum amount necessary to carry out the purposes of the Service Agreement. Associate will limit its uses and disclosures of, and requests for, PHI to the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request.

7. Obligations of Entity . Entity shall notify Associate of (i) any limitations in its notice of privacy practices, (ii) any changes in, or revocation of, permission by an individual to use or disclose PHI, and (iii) any confidential communication request or restriction on the use or disclosure of PHI that Entity has agreed to or with which Entity is required to comply, to the extent any of the foregoing affect Associate’s use or disclosure of PHI to perform its obligations as described in the Service Agreement.


8. Access and Amendment . In accordance with 45 C.F.R. § 164.524, Associate will permit Entity or, at Entity’s request, an individual (or the individual’s designee) to inspect and obtain copies of any PHI about the individual that is in Associate’s custody or control and that is maintained in a Designated Record Set. If the requested PHI is maintained electronically, Associate must provide a copy of the PHI in the electronic form and format requested by the individual, if it is readily producible, or, if not, in a readable electronic form and format as agreed to by Entity and the individual. Associate will notify Entity of any request (including but not limited to subpoenas) that Associate receives for access to PHI that is in Associate’s custody or control within five (5) business days of receipt of such request. Entity shall be responsible for making determinations about access. Associate will, upon receipt of notice from Entity, promptly amend or permit Entity access to amend any portion of the PHI that is in Associate’s custody or control so that Entity may meet its amendment obligations under 45 C.F.R. § 164.526.

9. Disclosure Accounting . Except for disclosures excluded from the accounting obligation by the HIPAA Rules and regulations issued pursuant to HITECH, Associate will record for each disclosure that Associate makes of PHI the information necessary for Entity to make an accounting of disclosures pursuant to the HIPAA Rules. In the event the U.S. Department of Health and Human Services (“ HHS ”) finalizes regulations requiring Covered Entities to provide access reports, Associate shall also record such information with respect to electronic PHI held by Associate as would be required under the regulations for Covered Entities beginning on the effective date applicable to Entity. Associate will make information required by this Section 9 available to Entity promptly upon Entity’s request for the period requested, but for no longer than the six (6) years preceding Entity’s request for the information or such other period required by the HIPAA Rules (except Associate need not have any information for disclosures occurring before the effective date of any previous HIPAA business associate agreements between the parties or, if none, the effective date of this Addendum).

10. Inspection of Books and Records . Associate will make its internal practices, books, and records, relating to its use and disclosure of PHI available upon request to Entity or HHS to determine Entity’s compliance with the HIPAA Rules.

11. Reporting . To the extent Associate becomes aware or discovers any use or disclosure of PHI not permitted by this Addendum, any Security Incident involving electronic PHI, any Breach of Unsecured Protected Health Information or any Red Flag (as defined at 16 C.F.R. § 681.2(b)) related to any individual who is the subject of PHI, Associate shall promptly report such use, disclosure, Security Incident, Breach or Red Flag to Entity. Associate shall mitigate, to the extent practicable, any harmful effect known to it of a Security Incident, Breach or use or disclosure of PHI by Associate not permitted by this Addendum. Notwithstanding the foregoing, the parties acknowledge and agree that this Section 11 constitutes notice by Associate to Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents (as defined below) for which no additional notice to Entity shall be required. “Unsuccessful Security Incidents” shall include, but not be limited to, pings and other broadcast attacks on Associate’s firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or


disclosure of electronic PHI. All reports of Breaches shall be made within ten (10) business days of Associate discovering the Breach and shall comply with and include the information specified at 45 C.F.R. § 164.410. Associate shall promptly reimburse Entity all reasonable costs incurred by Entity with respect to providing notification of and mitigating a Breach involving Associate, including but not limited to printing, postage costs and toll-free hotline costs.

12. Confidentiality of Alcohol and Drug Abuse Patient Records . Associate: (1) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from Entity about individuals who are patients of Entity (“ Patients ”), it is fully bound by the provisions of the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2; and (2) undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to Patients otherwise than as expressly provided for in the Part 2 Regulations.

13. Term and Termination . This Addendum shall be effective as of the effective date of the Service Agreement and shall remain in effect until termination of the Service Agreement. Either party may terminate this Addendum and the Service Agreement effective immediately if it determines that the other party has breached a material provision of this Addendum and failed to cure such breach within thirty (30) days of being notified by the other party of the breach. If the non-breaching party determines that cure is not possible, such party may terminate this Addendum and the Service Agreement effective immediately upon written notice to other party.

Upon termination of this Addendum for any reason, Associate will, if feasible, return to Entity or securely destroy all PHI maintained by Associate in any form or medium, including all copies of such PHI, at no cost to Entity. Further, Associate shall recover any PHI in the possession of its agents and subcontractors and return to Entity or securely destroy all such PHI. Notwithstanding the foregoing, Associate shall notify Entity and receive Entity’s written consent prior to destroying any PHI of which Entity does not maintain a duplicate copy. In the event that Associate determines that returning or destroying any PHI is infeasible, Associate shall promptly notify Entity of the conditions that make return or destruction infeasible. With regard to any PHI that Entity agrees cannot feasibly be returned to Entity or destroyed, Associate may maintain such PHI but shall continue to abide by the terms and conditions of this Addendum with respect to such PHI and shall limit its further use or disclosure of such PHI to those purposes that make return or destruction of the PHI infeasible. Associate shall comply with this Section 13 within thirty (30) days of termination of this Addendum. Associate shall provide Entity with written certification of its compliance with this Section 13 within forty-five (45) days of termination of this Addendum. Upon termination of this Addendum for any reason, all of Associate’s obligations under this Addendum shall survive termination and remain in effect (a) until Associate has completed the return or destruction of PHI as required by this Section 13 and (b) to the extent Associate retains any PHI pursuant to this Section 13 .

14. General Provisions . In the event that any final regulation or amendment to final regulations is promulgated by HHS or other government regulatory authority with respect to PHI, this Addendum will automatically be amended to remain in compliance with such regulations, and Associate shall promptly amend its contracts, if any, with subcontractors and agents to conform to the terms of this Addendum. Any ambiguity in this Addendum shall be resolved to permit Entity to comply with the HIPAA Rules and the Part 2 Regulations. Nothing


in this Addendum shall be construed to create any rights or remedies in any third parties or any agency relationship between the parties. A reference in this Addendum to a section in the HIPAA Rules or the Part 2 Regulations means the section as in effect or as amended. This Addendum replaces and supersedes and previous business associate agreements between the parties. The terms and conditions of this Addendum override and control any conflicting term or condition of the Service Agreement. To the extent Associate has limited its liability under the terms of the Service Agreement by a maximum recovery for direct damages, disclaimer against any consequential, indirect or punitive damages or any other limitation, all limitations shall exclude any damages to Entity arising from Associate’s breach of its obligations under this Addendum. All non-conflicting terms and conditions of the Service Agreement remain in full force and effect.

Exhibit 10.46

AMENDED AND RESTATED LOAN AGREEMENT

THIS AMENDED AND RESTATED LOAN AGREEMENT (“ Agreement ”) is executed as of August 13, 2014 (the “ Effective Date ”), by and between GREENHOUSE REAL ESTATE, LLC, a Texas limited liability company (“ Borrower ”), and WELLS FARGO BANK, NATIONAL ASSOCIATION (“ Lender ”). The Borrower and Lender are collectively referred to herein as the “Parties” and individually as a “Party.”

RECITALS

 

A. Borrower has requested that Lender amend and restate the Building Loan Agreement, dated as of October 8, 2013, between Borrower and Lender (as amended by the Consent and First Amendment to Loan Agreement, dated as of April 15, 2014, the “ Prior Loan Agreement ”), which the Lender is agreeable to granting subject to the terms and conditions contained herein.

 

B. Borrower owns certain real property described in Exhibit A hereto (“ Property ”).

 

C. NOW, THEREFORE. Borrower and Lender agree to amend and restate the Prior Loan Agreement as follows:

ARTICLE 1. LOAN

 

1.1 LOAN . By and subject to the terms of this Agreement, Lender agrees to lend to Borrower and Borrower agrees to borrow from Lender the principal sum of TWELVE MILLION SEVEN HUNDRED FORTY THOUSAND AND NO/100THS DOLLARS ($12,740,000.00) (“ Loan ”), said sum to be evidenced by a Real Estate Term Note of even date herewith (“ Note ”). Borrower acknowledges and agrees that as of the Effective Date $12,740,000.00 in principal amount of loan is outstanding under the Prior Loan Agreement, and all of such loan shall constitute Loan under this Agreement. The Note shall continue to be secured, in part, by that certain Amended and Restated Deed of Trust, Assignment of Rent and Leases, Security Agreement and Fixture Filing, dated as of the Effective Date (as amended, restated, supplemented or otherwise modified from time to time, the “ Deed of Trust ”), which amended and restated Construction Deed of Trust with Absolute Assignment of Leases and Rents, Security Agreement and Fixture Filing, dated as of October 8, 2013 and recorded under Instrument # D213269290 in Tarrant County, Texas , encumbering the Property. The obligations of the Borrower under the Loan will continue to be guaranteed by MICHAEL CARTWRIGHT, an individual (“ Cartwright ”), JERROD MENZ, an individual (“ Menz ”), AMERICAN ADDICTION CENTERS, INC., a Nevada corporation (“ AAC ”), and BEHAVIORAL HEALTHCARE REALTY, LLC, a Delaware limited liability company (“ BHR ” and, collectively, together with Cartwright, Menz and AAC, “ Guarantors ”,) pursuant to those certain Repayment Guaranty, dated as of October 8, 2013 (as amended, restated, supplemented or otherwise modified from time to time, the “ Repayment Guaranty ”), and the Completion Guaranty, dated as of October 8, 2013 (as amended, restated, supplemented or otherwise modified from time to time, the “ Completion Guaranty ”). Amounts disbursed to or on behalf of Borrower pursuant to the Note used or shall be used to finance the Property and for such other purposes and uses as may be permitted under this Agreement and the other Loan Documents, as described below. The Loan is not a revolving credit line, and no payments or credits shall increase the maximum amount of advances available from the Loan. Once repaid, whether such repayment is voluntary or required, the Loan may not be reborrowed.

 

1.2 LOAN DOCUMENTS . To the extent not previously delivered to Lender, Borrower shall deliver to Lender concurrently with this Agreement the Note and any other documents required by Lender, as amended, supplemented, replaced or modified from time to time, each properly executed and in recordable form, as applicable, described in Exhibit B (“ Loan Documents ”) together with those documents described in Exhibit B as other related documents.

 

1.3 MATURITY DATE . The maturity date of the Loan shall August 13, 2019 (“ Maturity Date ”).

 

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1.4 FULL REPAYMENT AND SATISFACTION . Upon receipt of all sums owing and outstanding under the Loan Documents, Lender shall issue a full release and reconveyance of the Property and Improvements from the lien of the Deed of Trust; provided, however , that each of the following conditions shall be satisfied at the time of, and with respect to, such release and reconveyance: (a) Lender shall have received all escrow, closing and recording costs, the costs of preparing and delivering such satisfaction and any sums then due and payable under the Loan Documents; (b) Lender shall have received a written release satisfactory to Lender of any set aside letter, letter of credit or other form of undertaking which Lender has issued to any surety, governmental agency or any other party in connection with the Loan and/or the Property; and (c) Lender’s obligation, if any, to make further disbursements under the Loan shall terminate as to any portion of the Loan undisbursed as of the date of issuance of such release and reconveyance, and any commitment of Lender to lend any undisbursed portion of the Loan shall be cancelled.

ARTICLE 2. DISBURSEMENT

 

2.1 CONDITIONS PRECEDENT . Lender’s obligation to enter into this Agreement and to consummate the transactions contemplated by this Agreement shall be subject to satisfaction of each of the following conditions precedent:

 

  a. To the extent not previously delivered to Lender, Lender shall have received fully executed originals of all Loan Documents, the Guaranties and any other documents, instruments, policies, title endorsements, and other materials requested by Lender under the terms of this Agreement or any of the other Loan Documents;

 

  b. There shall exist no Default as defined in this Agreement or any of the other Loan Documents or any event, omission or failure of condition which would constitute a Default after notice or lapse of time, or both;

 

  c. Lender shall have received an executed copy of a lease (‘‘ GTC Lease ’’), in form and substance acceptable to Lender, executed by Borrower, as “ Landlord ”, and Greenhouse Treatment Center, LLC, a Texas limited liability company (“ GTC ”), as “ Tenant ’’;

 

  d. Lender shall have received an executed copy of the guaranty to the GTC lease, in form and substance acceptable to Lender, executed by AAC as guarantor;

 

  e. Lender shall have obtained an appraisal of the Property, at Borrower’s expense, indicating, to the reasonable satisfaction of Lender, that the ratio of (x) the principal balance of the Loan to (y) the most recent appraised value of the Property based on the appraisal obtained by Lender prior to the date hereof, as adjusted by Lender in its sole discretion upon its review of the most recent appraisal does not exceed 65%; and

 

  f. Lender shall have received a copy of AAC’s annual financial statements for the fiscal year ending December 31, 2013, which financial statements shall be audited by an independent certified public accountant (“ CPA ”) acceptable to Lender and a copy of AAC’s quarterly financial statements for the fiscal quarter ending March 31, 2014.

 

2.2 POST-CLOSING COVENANTS .

 

  a. After the Effective Date, Borrower shall deliver a date down endorsement issued by Steward Title Guaranty Company with respect to the existing title report with respect to the Property delivered to Lender, in form and substance reasonably acceptable to Lender, together with such endorsements as Lender may reasonably require.

 

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2.3 FUNDS TRANSFER DISBURSEMENTS .

 

  a. Borrower agrees to be bound by any transfer request: (i) authorized or transmitted by Borrower; or, (ii) made in Borrower’s name and accepted by Lender in good faith and in compliance with these transfer instructions, even if not properly authorized by Borrower. Borrower further agrees and acknowledges that Lender may rely solely on any bank routing number or identifying bank account number or name provided by Borrower to affect a wire or funds transfer even if the information provided by Borrower identifies a different bank or account holder than named by the Borrower. Lender is not obligated or required in any way to take any actions to detect errors in information provided by Borrower. If Lender takes any actions in an attempt to detect errors in the transmission or content of transfer or requests or takes any actions in an attempt to detect unauthorized funds transfer requests, Borrower agrees that no matter how many times Lender takes these actions Lender will not in any situation be liable for failing to take or correctly perform these actions in the future and such actions shall not become any part of the transfer disbursement procedures authorized under this provision or the Loan Documents. Borrower agrees to notify Lender of any errors in the transfer of any funds or of any unauthorized or improperly authorized transfer requests within 14 days after Lender’s confirmation to Borrower of such transfer.

 

  b. Lender will, in its sole discretion, determine the funds transfer system and the means by which each transfer will be made. Lender may delay or refuse to accept a funds transfer request if the transfer would: (i) violate the terms of this authorization; (ii) require use of a bank unacceptable to Lender or prohibited by government authority; (iii) cause Lender to violate any Federal Reserve or other regulatory risk control program or guideline; or (iv) otherwise cause Lender to violate any applicable law or regulation.

 

  c. Lender shall not be liable to Borrower or any other parties for (i) errors, acts or failures to act of others, including other entities, banks, communications carriers or clearinghouses, through which Borrower’s transfers may be made or information received or transmitted, and no such entity shall be deemed an agent of the Lender, (ii) any loss, liability or delay caused by fires, earthquakes, wars, civil disturbances, power surges or failures, acts of government, labor disputes, failures in communications networks, legal constraints or other events beyond Lender’s control, or (iii) any special, consequential, indirect or punitive damages, whether or not (A) any claim for these damages is based on tort or contract or (B) Lender or Borrower knew or should have known the likelihood of these damages in any situation. Lender makes no representations or warranties other than those expressly made in this Agreement.

ARTICLE 3. INSURANCE

Borrower shall, while any obligation of Borrower or Guarantors under any Loan Document remains outstanding, maintain at Borrower’s sole expense, with licensed insurers approved by Lender, the following policies of insurance in form and substance satisfactory to Lender:

 

3.1 TITLE INSURANCE . A standard Texas promulgated form Policy of Title Insurance (“ Title Policy ”) issued by Stewart Title Guaranty Company, insuring Lender, in the principal amount of the Loan, of the validity and the priority of the lien of the Deed of Trust upon the Property, subject only to matters approved by Lender in writing. During the term of the Loan, Borrower shall deliver to Lender, within 5 days of Lender’s written request, such other endorsements to the Title Policy as Lender may reasonably require.

 

3.2 PROPERTY INSURANCE . An All Risk/Special Form Property Insurance policy, including without limitation, theft coverage and such other coverages and endorsements as Lender may require, insuring Lender against damage to the Property in an amount not less than 100% of the full replacement cost of the Property. Such coverage shall adequately insure any and all Loan collateral, whether such collateral is onsite, stored offsite or otherwise. Lender shall be named on the policy as Mortgagee and named under a Lender’s Loss Payable Endorsement or Standard Mortgagee Clause Endorsement (in form acceptable to Lender).

 

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3.3 FLOOD HAZARD INSURANCE . A policy of flood insurance, as required by applicable governmental regulations, or as deemed necessary by Lender, in an amount required by Lender, but in no event less than the amount sufficient to meet the requirements of applicable law and governmental regulation.

 

3.4 LIABILITY INSURANCE . A policy of Commercial General Liability insurance on an occurrence basis, with coverages and limits as required by Lender, insuring against liability for injury and/or death to any person and/or damage to any property occurring on the Property.

 

3.5 OTHER COVERAGE . Borrower shall provide to Lender evidence of such other reasonable insurance in such reasonable amounts as Lender may from time to time request against such other insurable hazards which at the time are commonly insured against for property similar to the Property located in or around the region in which the Property is located. Such coverage requirements may include but are not limited to coverage for earthquake, acts of terrorism, mold, business income, delayed business income, rental loss, sink hole, soft costs, tenant improvement or environmental.

 

3.6 GENERAL . Borrower shall provide to Lender insurance certificates or other evidence of coverage in form acceptable to Lender, with coverage amounts, deductibles, limits and retentions as required by Lender. All insurance policies shall provide that the coverage shall not be cancelable or materially changed without 10 days prior written notice to Lender of any cancellation for nonpayment of premiums, and not less than 30 days prior written notice to Lender of any other cancellation or any modification (including a reduction in coverage). Lender shall be named under a Lender’s Loss Payable Endorsement or a Standard Mortgagee Clause Endorsement (in form acceptable to Lender) on all insurance policies which Borrower actually maintains with respect to the Property. All insurance policies shall be issued and maintained by insurers approved to do business in the state in which the Property is located and must have an A.M. Best Company financial rating and policyholder surplus acceptable to Lender.

ARTICLE 4. REPRESENTATIONS AND WARRANTIES

As a material inducement to Lender’s entry into this Agreement, Borrower represents and warrants to Lender as of the Effective Date and continuing thereafter, until the repayment of the Loan and other obligations under the Loan Documents in full in cash and the full release and reconveyance of the lien of the Deed of Trust, the following. As used in this Agreement, the phrase “to the best of Borrower’s knowledge” shall mean the actual knowledge of Cartwright and Menz after reasonable investigation and inquiry.

 

4.1 AUTHORITY/ENFORCEABILITY . To the best of Borrower’s knowledge, Borrower is in compliance with all laws and regulations applicable to its organization, existence and transaction of business and has all necessary rights and powers to own and operate the Property as contemplated by the Loan Documents.

 

4.2 BINDING OBLIGATIONS . Borrower is authorized to execute, deliver and perform its obligations under the Loan Documents, and such obligations are the valid and binding obligations of Borrower.

 

4.3 COMPLIANCE WITH LAWS . To the best of Borrower’s knowledge, Borrower has, and at all times shall have, all permits, licenses, exemptions, and approvals necessary to occupy, operate and market the Property, and shall maintain compliance with all governmental requirements applicable to the Property, and all other applicable statutes, laws, regulations and ordinances necessary for the transaction of its business. To the best of Borrower’s knowledge, the Property is a legal parcel lawfully created in full compliance with all subdivision laws and ordinances. Without limiting the generality of the foregoing, GTC will have all permits, licenses, exemptions, and approvals necessary to use and operate the Property as an outpatient treatment facility, and such use and operation of the Property constitutes a permitted use under all applicable zoning regulations.

 

4.4 LITIGATION . Except as disclosed to Lender in writing, to the best of Borrower’s knowledge, there are no claims, actions, suits, or proceedings pending, or to the best of Borrower’s knowledge threatened, against Borrower or any Guarantor or affecting the Property.

 

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4.5 FINANCIAL CONDITION . All financial statements and information heretofore and hereafter delivered to Lender by Borrower, including, without limitation, information relating to the financial condition of Borrower, the Property, the partners, joint venturers or members of Borrower, and/or any Guarantor, fairly and accurately represent the financial condition of the subject thereof and have been prepared (except as noted therein) in accordance with generally accepted accounting principles consistently applied. Borrower acknowledges and agrees that Lender may request and obtain additional information from third parties regarding any of the above, including, without limitation, credit reports.

 

4.6 ACCURACY . To the best of Borrower’s knowledge, all reports, documents, instruments, information and forms of evidence delivered to Lender concerning the Loan or security for the Loan or required by the Loan Documents are accurate, correct and sufficiently complete to give Lender true and accurate knowledge of their subject matter, and do not contain any misrepresentation or omission.

 

4.7 UTILITIES . All utility services, including, without limitation, gas, water, sewage, electrical and telephone, necessary for the occupancy of the Property are available at the Property.

 

4.8 BUSINESS LOAN . The Loan is a business loan transaction in the stated amount solely for the purpose of carrying on the business of Borrower and none of the proceeds of the Loan will be used for the personal, family or agricultural purposes of Borrower.

 

4.9 CONSTRUCTION . Construction work and activity will be performed at the Property, subject to Lender’s approval pursuant to the terms of the Loan Documents.

ARTICLE 5. HAZARDOUS MATERIALS

 

5.1 SPECIAL REPRESENTATIONS AND WARRANTIES . Without in any way limiting the other representations and warranties set forth in this Agreement, and after reasonable investigation and inquiry, Borrower hereby represents and warrants to the best of Borrower’s knowledge as of the date of this Agreement as follows:

 

  a. Hazardous Materials . Except as previously disclosed to Lender, the Property is not and has not been a site for the use, generation, manufacture, storage, treatment, release, threatened release, discharge, disposal, transportation or presence of any oil, flammable explosives, asbestos, urea formaldehyde insulation, radioactive materials, hazardous wastes, toxic or contaminated substances or similar materials, including, without limitation, any substances which are “hazardous substances,” “hazardous wastes,” “hazardous materials,” “toxic substances,” “wastes,” “regulated substances,” “industrial solid wastes,” or “pollutants or contaminants” under the Hazardous Materials Laws, as described below, and/or any other applicable environmental laws, ordinances and regulations (collectively, the “ Hazardous Materials ”). “Hazardous Materials” shall not include commercially reasonable amounts of such materials used in the ordinary course of operation of the Property which are used and stored in accordance with all applicable environmental laws, ordinances and regulations.

 

  b.

Hazardous Materials Laws . The Property is in compliance with all laws, ordinances and regulations relating to Hazardous Materials (“ Hazardous Materials Laws ”), including, without limitation: any and all applicable federal, state or local directive, statute, law, rule, regulation, ordinance or rule of common law in effect and any judicial or administrative decisions, including any judicial or administrative order, consent decree or judgment, relating to the control of any pollutant or hazardous material, the protection of the environment or the effect of the environment on human health, including the Comprehensive Environment Response, Compensation and Liability Act of 1980, as amended, 42 U.S.C. Section 9601 et seq .; the Resource Conservation and Recovery Act, as amended, 42 U.S.C. Section 6901 et seq .; the Federal Water Pollution Control Act, as amended, 33 U.S.C. Section 1252 et seq .; the Toxic Substances Control Act, as amended, 15 U.S.C. Section 2601 et seq .; the Clean Air Act, as

 

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  amended, 42 U.S.C. Section 7401 et seq .; the Safe Drinking Water Act, as amended, 42 U.S.C. Section 300f et seq .; the Hazardous Materials Transportation Act, as amended 49 U.S.C. Section 1801 et seq .; the Atomic Energy Act, as amended, 42 U.S.C. Section 2011 et seq .; the Federal Insecticide, Fungicide and Rodenticide Act, as amended, 7 U.S.C. Section 136 et seq .; the Occupational Safety and Health Act, as amended, 20 U.S.C. Section 65 i el seq.; and applicable state and local laws, regulations or requirements that govern (i) the existence, cleanup and/or remedy of contamination on Property; (ii) the protection of the environment from released, spilled, deposited or otherwise emplaced contamination; (iii) the control of hazardous wastes; or (iv) the use, generation, transport, treatment, removal or recovery of Hazardous Materials, including any and all building materials.

 

  c. Hazardous Materials Claims . There are no claims or actions (“ Hazardous Materials Claims ”) known to, pending or threatened against Borrower or the Property by any governmental entity or agency or by any other person or entity relating to Hazardous Materials or pursuant to the Hazardous Materials Laws.

 

  d. Border Zone Property . There has been no occurrence or condition on any real property adjoining or in the vicinity of the Property that could cause the Property or any part thereof to become contaminated through the migration of Hazardous Materials onto, above or under the Property.

 

5.2 HAZARDOUS MATERIALS COVENANTS . Borrower agrees as follows:

 

  a. No Hazardous Activities . Borrower shall not cause or permit the Property to be used as a site for the use, generation, manufacture, storage, treatment, release, discharge, disposal, transportation or presence of any Hazardous Materials.

 

  b. Compliance . Borrower shall comply and cause the Property to comply with all Hazardous Materials Laws.

 

  c. Notices . Borrower shall immediately notify Lender in writing of: (i) the discovery of any Hazardous Materials on, under or about the Property; (ii) any knowledge by Borrower that the Property do not comply with any Hazardous Materials Laws; (iii) any Hazardous Materials Claims known to Borrower; and (iv) Borrower’s discovery of any occurrence or condition on any real property adjoining or in the vicinity of the Property that could cause the Property or any part thereof to become contaminated with Hazardous Materials.

 

  d. Removal and/or Remedial Action . In response to the presence of any Hazardous Materials on, under or about the Property, Borrower shall immediately take, at Borrower’s sole expense, all actions required by any Hazardous Materials Laws or any regulatory agency, governing body, judgment, consent decree, settlement or compromise with respect to any Hazardous Materials Claims.

 

5.3 INSPECTION BY LENDER . Upon reasonable prior notice to Borrower, Lender, its employees and agents, may from time to time (whether before or after the commencement of a nonjudicial or judicial foreclosure proceeding) enter and inspect the Property during normal business hours for the purpose of determining the existence, location, nature and magnitude of any past or present release or threatened release of any Hazardous Materials into, onto, beneath or from the Property.

 

5.4 HAZARDOUS MATERIALS INDEMNITY . Borrower hereby agrees to defend, indemnify and hold harmless Lender, its directors, officers, employees, agents, successors and assigns from and against any and all losses, damages, liabilities, claims, actions, judgments, court costs and legal or other expenses (including, without limitation, attorneys’ fees and expenses) which Lender may incur as a direct or indirect consequence of the use, generation, release, manufacture, storage, disposal, threatened disposal, transportation or presence of Hazardous Materials in, on, under or about the Property. Borrower shall immediately pay to Lender upon demand any amounts owing under this indemnity, together with interest from the date the indebtedness arises until paid at the rate of interest applicable to the principal balance of the Note. Borrower’s duty and obligations to defend, indemnify and hold harmless Lender shall survive the cancellation of the Note and the release, reconveyance or partial reconveyance of the Deed of Trust.

 

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5.5 LEGAL EFFECT OF SECTION . Borrower and Lender agree that Borrower’s duty to indemnify Lender hereunder shall survive: (i) any judicial or non-judicial foreclosure under the Deed of Trust, or transfer of the Property in lieu thereof; (ii) the release and reconveyance or cancellation of the Deed of Trust; and (iii) the satisfaction of all of Borrower’s obligations under the Loan Documents.

ARTICLE 6. COVENANTS OF BORROWER

 

6.1 EXPENSES . Borrower shall immediately pay to Lender upon demand: (a) all costs and expenses incurred by Lender in connection with the administration of this Agreement, the other Loan Documents and any other documents required by Lender during the term of the Loan; and (b) the enforcement or satisfaction by Lender of any of Borrower’s or Guarantors’ obligations under this Agreement, the other Loan Documents and the Guaranty. For all purposes of this Agreement, Lender’s costs and expenses shall include, without limitation, all appraisal fees, cost engineering and inspection fees, legal fees and expenses, accounting fees, environmental consultant fees, auditor fees, and the cost to Lender of any title insurance premiums, title surveys, tax service contract fees, recording fees, mortgage registration taxes, release, reconveyance and notary fees. If any of the services described above are provided by an employee of Lender, Lender’s costs and expenses for such services shall be calculated in accordance with Lender’s standard charge for such services.

 

6.2 LEASING . Borrower will lease the Property to GTC pursuant to the GTC Lease. In the event of the termination of the GTC Lease, Borrower shall use commercially reasonable efforts to maintain all leasable space in the Property leased at no less than fair market rental rates.

 

6.3 APPROVAL OF LEASES . All leases of all or any part of the Property shall: (a) be upon terms and with tenants approved by Lender prior to Borrower’s execution of any such lease (which approval shall not be unreasonably withheld); and (b) include estoppel, subordination, attornment and mortgagee protection provisions satisfactory to Lender. All standard lease forms and any material deviation from any form, shall be approved by Lender prior to execution of any lease using such form.

 

6.4 INCOME TO BE APPLIED TO DEBT SERVICE . After the occurrence of a Default and during the pendency of a Default, Borrower shall apply all gross operating income from the Property only to the payment of operating expenses directly attributable to the Property and the payment of accrued interest and outstanding principal on the Loan. To the extent such gross operating income exceeds such operating expenses, such excess shall be used first to pay accrued interest (regardless of any interest reserve) and then to pay the outstanding principal on the Loan. After the occurrence of a Default, no gross operating income shall be distributed to any partner, venturer, member or equity investor of Borrower until such Default has been cured.

 

6.5 SUBDIVISION MAPS . Prior to recording any final map, plat, parcel map. lot line adjustment or other subdivision map of any kind covering any portion of the Property (“ Subdivision Map ”), Borrower shall submit such Subdivision Map to Lender for Lender’s review and approval, which approval shall not be unreasonably withheld. Within 10 Business Days (as defined in the Note) after Lender’s receipt of such Subdivision Map, Lender shall provide Borrower written notice if Lender disapproves of said Subdivision Map. Lender shall be deemed to have approved the Subdivision Map if such notice is not provided to Borrower. Within 5 Business Days after Lender’s request, Borrower shall execute, acknowledge and deliver to Lender such amendments to the Loan Documents as Lender may reasonably require to reflect the change in the legal description of the Property resulting from the recordation of any Subdivision Map. In connection with and promptly after the recordation of any amendment or other modification to the Deed of Trust recorded in connection with such amendments, Borrower shall deliver to Lender, at Borrower’s sole expense, a title endorsement to the Title Policy in form and substance satisfactory to Lender insuring the continued first priority lien of the Deed of Trust. Subject to the execution and delivery by Borrower of any documents required under this Section, Lender shall, if required by applicable law, sign any Subdivision Map approved, or deemed to be approved, by Lender pursuant to this Section.

 

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6.6 FURTHER ASSURANCES . Upon Lender’s request and at Borrower’s sole cost and expense, Borrower shall execute, acknowledge and deliver any other instruments and perform any other acts reasonably necessary, desirable or proper, as determined by Lender, to carry out the purposes of this Agreement and the other Loan Documents or to perfect and preserve any liens created by the Loan Documents.

 

6.7 ASSIGNMENT . Without the prior written consent of Lender, Borrower shall not assign Borrower’s interest under any of the Loan Documents, or in any monies due or to become due thereunder, and any assignment without such consent shall be void. In this regard, Borrower acknowledges that Lender would not make the Loan except in reliance on Borrower’s expertise, reputation, prior experience in developing and constructing commercial real property for dependency treatment facilities, Lender’s knowledge of Borrower, and Lender’s understanding that this Agreement is more in the nature of an agreement involving personal services than a standard loan where Lender would rely on security which already exists.

 

6.8 INDEMNITY . BORROWER HEREBY AGREES TO DEFEND, INDEMNIFY AND HOLD HARMLESS LENDER, ITS DIRECTORS, OFFICERS, EMPLOYEES, AGENTS, SUCCESSORS AND ASSIGNS FROM AND AGAINST ANY AND ALL LOSSES, DAMAGES, LIABILITIES, CLAIMS, ACTIONS, JUDGMENTS, COURT COSTS AND LEGAL OR OTHER EXPENSES (INCLUDING, WITHOUT LIMITATION, ATTORNEYS’ FEES AND EXPENSES) WHICH LENDER MAY INCUR AS A DIRECT OR INDIRECT CONSEQUENCE OF: (A) THE PURPOSE TO WHICH BORROWER APPLIES THE LOAN PROCEEDS; (B) THE FAILURE OF BORROWER TO PERFORM ANY OBLIGATIONS AS AND WHEN REQUIRED BY THIS AGREEMENT OR ANY OF THE OTHER LOAN DOCUMENTS; (C) ANY FAILURE AT ANY TIME OF ANY OF BORROWER’S REPRESENTATIONS OR WARRANTIES TO BE TRUE AND CORRECT; OR (D) ANY ACT OR OMISSION BY BORROWER, CONSTITUENT PARTNER OR MEMBER OF BORROWER, ANY CONTRACTOR, SUBCONTRACTOR OR MATERIAL SUPPLIER, ENGINEER, ARCHITECT OR OTHER PERSON OR ENTITY WITH RESPECT TO ANY OF THE PROPERTY. BORROWER SHALL IMMEDIATELY PAY TO LENDER UPON DEMAND ANY AMOUNTS OWING UNDER THIS INDEMNITY, TOGETHER WITH INTEREST FROM THE DATE THE INDEBTEDNESS ARISES UNTIL PAID AT THE RATE OF INTEREST APPLICABLE TO THE PRINCIPAL BALANCE OF THE NOTE. BORROWER’S DUTY AND OBLIGATIONS TO DEFEND, INDEMNIFY AND HOLD HARMLESS LENDER SHALL SURVIVE CANCELLATION OF THE NOTE AND THE RELEASE OR RECONVEYANCE OF THE DEED OF TRUST.

 

6.9 DERIVATIVE DOCUMENTS . Promptly upon request by Lender, Borrower shall enter into an interest rate swap transaction (or an amendment to existing rate swap transaction) with Lender or with another counterparty reasonably acceptable to Lender (such transaction, together with all documents and agreements relating thereto, including any ISDA Master Agreement, Schedule and/or Confirmation, together with all modifications, extensions, renewals and replacement thereof, is hereinafter referred to as the “ Swap Contract ”) to cover a notional amount of not less than 100%of the outstanding principal amount of the Loan for the full term of the Loan and shall maintain in full force and effect such Swap Contract for the full term of the Loan.

ARTICLE 7. REPORTING COVENANTS

 

7.1 FINANCIAL INFORMATION . Borrower shall deliver its tax return, prepared by a CPA and signed by Borrower, to Lender within 30 days after filing, but in no event later than November 15 of each year following the tax year to be reported, together with any other financial information including, without limitation, financial statements, cash flow projections, and operating statements as may be reasonably requested by Lender. Borrower shall also deliver to Lender the current CPA-audited, consolidated, annual financial statements (including, without limitation, an income and expense statement and a balance sheet) of AAC Holdings, Inc. (“ Holdings ”) and its subsidiaries as soon as available but in no event later than 120 days after the end of its fiscal year. Borrower shall also deliver to Lender the internally prepared, consolidated, quarterly financial statements (including, without limitation, an income and expense statement and a balance sheet) of Holdings and its subsidiaries as soon as available but in no event later than 45 days after the end of each fiscal quarter. Borrower shall cause each of Cartwright and Menz to deliver to Lender his self-prepared personal financial statement as soon as available, but in no event later than April 30 of each year following the tax year to be reported and his signed, CPA-prepared tax return within 30 days after filing but in no event later than November 15 each year end following the tax year to be reported.

 

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Within 30 days of Lender’s request, Borrower shall also deliver to Lender such annual or quarterly and other financial information, as the case may be, regarding any persons or entities in any way obligated on the Loan as Lender may specify. If audited financial information is prepared, Borrower shall deliver to Lender copies of that information within 45 days of its final preparation or not later than would be required by this Section 7.1, whichever is earlier. Except as otherwise agreed to by Lender, all such financial information shall be prepared in accordance with generally accepted accounting principles consistently applied.

 

7.2 LEASING REPORTS AND OPERATING STATEMENTS . Borrower shall deliver to Lender quarterly rent rolls, leasing schedules and reports. operating statements and/or such other leasing information as Lender shall request with respect to the Property, each in form and substance satisfactory to Lender.

 

7.3 UPDATED APPRAISAL; REMARGIN REQUIREMENT . Lender shall have the right (but not the obligation) at any time, and from time to time, during the term of the Loan, in Lender’s discretion, to request and obtain from an appraiser acceptable to Lender, an updated appraisal of the Property, which includes an opinion of value and supporting information reasonably acceptable to Lender. Lender will do everything in its control to contain the cost of the appraisal. If such an appraisal is obtained, Borrower agrees to cooperate with any appraiser, allow access to the Property and provide copies of leases, operating statements, plans and any other information reasonably requested by such appraiser. Borrower shall pay to Lender, within thirty (30) days following demand: (a) the cost of the updated appraisal; provided, however. that Borrower shall not be required to pay for more than one such appraisal in a given calendar year if a Default does not then exist; and (b) the amount, if any, by which the then outstanding balance of the Loan exceeds 65% of the then most recent appraised value of the Property, as adjusted by Lender in its sole discretion upon its review of the appraisal. Upon Borrower’s payment for the updated appraisal and execution of Lender’s then standard form of appraisal indemnity agreement, Borrower may obtain a copy of the updated appraisal if a Default does not then exist.

 

7.4 FINANCIAL CONDITION . Borrower shall maintain its financial condition during the term of this Agreement according to the following schedules, using generally accepted accounting principles, consistently applied:

 

  a. From and after the Effective Date, Borrower shall cause Holdings to maintain, a Fixed Charge Coverage Ratio of not less than 1.25 to 1.00 as of each fiscal quarter end, determined on a rolling 4-quarter basis. For purposes hereof, (A) the term “ Fixed Charge Coverage Ratio ” means for Holdings and its subsidiaries, on a consolidated basis, (x) the aggregate of EBITDA (as defined in the AAC Credit Agreement) minus (1) 100% of Capital Expenditures (as defined in the AAC Credit Agreement, as defined below) during such period, minus (2) Restricted Payments (as defined in the AAC Credit Agreement) made by Holdings, AAC or BHR to its equity holders during such period (without duplication), excluding any Restricted Payments in connection with the Initial Reorganization Transactions (as defined in the AAC Credit Agreement) paid on April 15, 2014 that are permitted under the AAC Credit Agreement, minus (3) total amount of Permitted Acquisitions (as defined in the AAC Credit Agreement) made during such period divided by (y) the aggregate of total interest expense for such period plus scheduled debt amortization or maturity payments or redemptions for such period, excluding, however, for purposes of this clause (y), the Reliant Debt (as defined in the AAC Credit Agreement) to the extent repaid with the proceeds of the Holdings IPO (as defined in the AAC Credit Agreement) and the Existing Term Loan B (as defined in the AAC Credit Agreement); and (B) the term “ AAC Credit Agreement ” means the Second Amended and Restated Credit Agreement, dated as of April 15, 2014, by and among Holdings, Borrower, the lenders party thereto, and Wells Fargo Bank, National Association, as administrative agent and collateral agent, as amended, restated, supplemented or otherwise modified from time to time.

 

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ARTICLE 8. DEFAULTS AND REMEDIES

 

8.1 DEFAULT . The occurrence of any one or more of the following shall constitute an event of default (“ Default ”) under this Agreement and the other Loan Documents:

 

  a. Monetary . Borrower’s failure to pay within 5 days when due any sums payable under the Note or any of the other Loan Documents or Borrower’s failure to deposit any funds as and when required under this Agreement; or

 

  b. Performance of Obligations . Borrower’s or any Guarantor’s failure to perform any obligation, covenant or condition under this Agreement, the Note or any of the other Loan Documents; provided , however , that if a cure period is provided for the remedy of such failure. Borrower’s or such Guarantor’s failure to perform will not constitute a Default until such date as the specified cure period expires; or

 

  c. Lien; Attachment; Condemnation . (i) The recording or service upon Lender of any claim of lien against the Property and the continuance of such claim of lien for 30 days after such recording or service without discharge, satisfaction or provision for payment being made by Borrower in a manner satisfactory to Lender; or (ii) the condemnation, seizure or appropriation of or occurrence of an uninsured casualty with respect to, any material portion of the Property; or (iii) the sequestration or attachment, or any levy or execution upon, any of the Property or any other collateral provided by Borrower or any other party under any of the Loan Documents which is not released, expunged or dismissed within 30 days; or

 

  d. Representations and Warranties . (i) The failure of any representation or warranty of Borrower or any Guarantor in any of the Loan Documents and the continuation of such failure for more than 30 days after written notice to Borrower or Guarantor from Lender requesting that Borrower or such Guarantor cure such failure; or (ii) any material adverse change in the financial condition of Borrower, any Guarantor, or any indemnitor from the financial condition represented to Lender as of the later of: (A) the Effective Date; or (B) the date upon which the financial condition of such party was first represented to Lender; or

 

  e. Bankruptcy; Insolvency; Dissolution . (i) The filing of by Borrower, any Guarantor, any partner or member of Borrower, any indemnitor or any non-borrower trustor of a petition for relief under the Bankruptcy Reform Act of 1978 (11 USC Section 101-1330) as now or hereafter amended or recodified (“ Bankruptcy Code ”), or under any other present or future state or federal law regarding bankruptcy, reorganization or other debtor relief law; (ii) the filing against Borrower, any Guarantor, any partner or member of Borrower, any indemnitor or any non-borrower trustor of an involuntary proceeding under the Bankruptcy Code or other debtor relief law and the failure of Borrower to effect a full dismissal of such proceeding within 30 days after the date of filing such proceeding; (iii) a general assignment by Borrower, any Guarantor, any partner or member of Borrower, any indemnitor or any non-borrower trustor for the benefit of creditors; or (iv) Borrower, any Guarantor, any partner or member of Borrower, any indemnitor or any non-borrower trustor applying for, or the appointment of, a receiver, trustee, custodian or liquidator of Borrower or any of its property; or

 

  f. Borrower; Key Person or Entity . The retirement, death, incapacity or withdrawal of Borrower or any Guarantor, if an individual, or the retirement, death, incapacity or withdrawal of Michael Cartwright as manager of Borrower and Borrower’s failure to provide a substitute or replacement reasonably acceptable to Lender within 30 days after the occurrence of any such retirement, death, incapacity or withdrawal; or

 

  g.

Transfer of Assets . The sale, assignment, pledge, hypothecation, mortgage or transfer of all or a substantial portion of the assets of Borrower. Notwithstanding the foregoing or anything in the Loan Documents to the contrary, the Lender hereby consents to (i) the transfer of all of the common equity interests of BHR from Holdings to AAC, (ii) a subsidiary short-form merger of a

 

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  merger sub owned by Holdings with and into AAC pursuant to which AAC will become a direct wholly-owned subsidiary of Holdings, and (iii) conversion of AAC from a corporation into a limited liability company or other limited liability entity, in each case, without any further consent of Lender (collectively, the “ Subsequent BHR Transactions ”), provided that the Subsequent BHR Transactions shall be consummated on or prior to March 31, 2015 and Borrower will notify Lender in writing promptly (but, in any event within thirty (30) days) after the consummation of the Subsequent BHR Transactions; or

 

  h. Derivative Default . The occurrence of a default by Borrower or a termination event with respect to Borrower under any swap, derivative, foreign exchange or hedge transaction or arrangement (or other similar transaction or arrangement howsoever described or defined) at any time entered into between Borrower and Lender in connection with the Loan including, without limitation, the Swap Contract; or

 

  i. Default Under Guaranty . The occurrence of a default under any guaranty now or hereafter executed in connection with the Loan, including, without limitation, any Guarantor’s (defined parties) or other guarantor’s failure to perform any covenant, condition, or obligation thereunder; or

 

  j. Default Under Unsecured Indemnity Agreement . The occurrence of a default under that certain Hazardous Materials Indemnity Agreement (Unsecured) executed by Guarantors as Indemnitors, in favor of Lender, of even date herewith, including without limitation, Indemnitor’s failure to perform any covenant, condition, or obligation thereunder; or

 

  k. Default Under GTC Lease . The occurrence of a default by either landlord or tenant under, or the surrender, abandonment, termination or rescission of the GTC Lease; or

 

  l. Default Under Other Indebtedness . The occurrence of a default by Borrower or any Guarantor or any affiliate or subsidiary of Borrower or any Guarantor with respect to any other indebtedness, whether as a borrower or a guarantor thereunder, under any agreement with any lender, including without limitation, Lender, or any Disqualified Equity Interests of Borrower, any Guarantor or any of their respective subsidiaries shall be payable or otherwise be required to be paid (if the required payments exceed in the aggregate $500,000) or an event of default (if the outstanding amount of such Disqualified Equity Interests exceeds $500,000) thereunder shall occur. As used herein, the term “ Disqualified Equity Interests ” means any equity interest that, by its terms (or by the terms of any security or other equity interests into which it is convertible or for which it is exchangeable), or upon the happening of any event or condition (i) matures or is mandatorily redeemable (other than solely for Qualified Equity Interests), pursuant to a sinking fund obligation or otherwise (except as a result of a change of control or asset sale so long as any rights of the holders thereof upon the occurrence of a change of control or asset sale event shall be subject to the prior repayment in full of the Loan), (ii) is redeemable at the option of the holder thereof (other than solely for Qualified Equity Interests), in whole or in part, (iii) provides for the scheduled payments of dividends in cash, or (iv) is or becomes convertible into or exchangeable for indebtedness or any other equity interests that would constitute Disqualified Equity Interests, in each case, prior to the date that is 180 days after the latest maturity date of the Loan; and the term “ Qualified Equity Interests ” means any equity interests issued by Holdings (and not by any of its subsidiaries) that is not a Disqualified Equity Interest.

 

8.2 ACCELERATION UPON DEFAULT; REMEDIES . Upon the occurrence of any Default specified herein, Lender may, at its sole option, declare all sums owing to Lender under the Note, this Agreement and the other Loan Documents immediately due and payable. Upon such acceleration, Lender may, in addition to all other remedies permitted under the Note and this Agreement and the other Loan Documents and at law or equity, apply the funds of Borrower in its possession, if any, to the sums owing under the Loan Documents and any and all obligations of Lender to fund further disbursements under the Loan shall terminate.

 

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8.3 DISBURSEMENTS TO THIRD PARTIES . Upon the occurrence of a Default occasioned by Borrower’s failure to pay money to a third party as required by this Agreement, Lender may but shall not be obligated to make such payment from the Loan proceeds or other funds of Lender. If such payment is made from proceeds of the Loan, Borrower shall deposit with Lender, upon written demand, an amount equal to such payment within five (5) days of such demand. If such payment is made from funds of Lender, Borrower shall repay such funds upon written demand of Lender within five (5) days of such demand. In either case, the Default with respect to which any such payment has been made by Lender shall not be deemed cured until such deposit or repayment (as the case may be) has been made by Borrower to Lender.

 

8.4 SET OFF . Upon the occurrence of a Default, Lender may set off any and all amounts due by Borrower against any indebtedness or obligation of Lender to Borrower.

 

8.5 RIGHTS CUMULATIVE; NO WAIVER . All Lender’s rights and remedies provided in this Agreement, the other Loan Documents and the Guaranty, together with those granted by law or at equity, are cumulative and may be exercised by Lender at any time. Lender’s exercise of any right or remedy shall not constitute a cure of any Default unless all sums then due and payable to Lender under the Loan Documents are repaid and Borrower has cured all other Defaults. No waiver shall be implied from any failure of Lender to take, or any delay by Lender in taking, action concerning any Default or failure of condition under the Loan Documents, or from any previous waiver of any similar or unrelated Default or failure of condition. Any waiver or approval under any of the Loan Documents must be in writing and shall be limited to its specific terms. Any funds expended by Lender in the exercise of its rights or remedies under this Agreement and the other Loan Documents shall be payable to Lender upon demand, together with interest at the rate applicable to the principal balance of the Note from the date the funds were expended.

ARTICLE 9. MISCELLANEOUS PROVISIONS

 

9.1 NOTICES . All notices, demands, requests or other communications under this Agreement and the other Loan Documents shall be in writing and shall be delivered in accordance with the notice provisions contained in the Deed of Trust.

 

9.2 RELATIONSHIP OF PARTIES . The relationship of Borrower and Lender under the Loan Documents is, and shall at all times remain, solely that of borrower and lender, and Lender neither undertakes nor assumes any responsibility or duty to Borrower or to any third party with respect to the Property, except as expressly provided in this Agreement and the other Loan Documents.

 

9.3 ATTORNEYS’ FEES AND EXPENSES; ENFORCEMENT . If any attorney is engaged to enforce or defend any provision of this Agreement, any of the other Loan Documents or as a consequence of any Default under the Loan Documents, with or without the filing of any legal action or proceeding, and including, without limitation, any fees and expenses incurred in any bankruptcy proceeding of Borrower or in connection with any appeal of a lower court decision, the prevailing Party, as agreed to by the Parties or as determined by the court, shall be entitled to its reasonable attorneys’ fees and expenses and all costs incurred in connection therewith.

 

9.4 IMMEDIATELY AVAILABLE FUNDS . All amounts payable by Borrower to Lender shall be (a) payable only in United States currency in immediately available funds, and (b) received by Lender at the Denver Loan Center, Attention: Payments, 1700 Lincoln Street, Denver, CO 80203, or at such other places as may be designated in writing by Lender, no later than 11 AM Pacific Standard Time or Pacific Daylight Time, as applicable. Any amounts received after such time shall be credited the next Business Day.

 

9.5

LOAN SALES AND PARTICIPATIONS; DISCLOSURE OF INFORMATION . Borrower agrees that Lender may elect, at any time, to sell, assign or grant participations in all or any portion of its rights and obligations under the Loan Documents, and that any such sale, assignment or participation may be to one or more financial institutions, private investors, and/or other entities, at Lender’s sole discretion. Borrower further agrees that Lender may disseminate to any such actual or potential purchaser(s), assignee(s) or participant(s) all documents and information (including, without limitation, all financial information) which has been or is hereafter provided to or known to Lender with respect to: (a) the Property and its operation;

 

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  (b) any party connected with the Loan (including, without limitation, the Borrower, any partner of Borrower, any constituent partner or member of Borrower, any Guarantor, any indemnitor and any non-borrower mortgagor); and/or (c) any lending relationship other than the Loan which Lender may have with any party connected with the Loan. The indemnity obligations of Borrower under the Loan Documents shall also apply with respect to any purchaser, assignee or participant.

 

9.6 LENDER’S AGENTS . Lender may designate an agent or independent contractor to exercise any of Lender’s rights under this Agreement and any of the other Loan Documents. Any reference to Lender in any of the Loan Documents shall include Lender’s agents, employees or independent contractors. Borrower shall pay the costs of such agent or independent contractor either directly to such person or to Lender in reimbursement of such costs, as applicable.

 

9.7 WAIVER OF RIGHT TO TRIAL BY JURY . EACH PARTY TO THIS AGREEMENT HEREBY EXPRESSLY WAIVES, TO THE FULLEST EXTENT NOW OR HEREAFTER PERMITTED UNDER APPLICABLE LAW, ANY RIGHT TO TRIAL BY JURY OF ANY CLAIM, DEMAND, ACTION OR CAUSE OF ACTION (a) ARISING UNDER THE LOAN DOCUMENTS, INCLUDING, WITHOUT LIMITATION, ANY PRESENT OR FUTURE MODIFICATION THEREOF OR (b) IN ANY WAY CONNECTED WITH OR RELATED OR INCIDENTAL TO THE DEALINGS OF THE PARTIES HERETO OR ANY OF THEM WITH RESPECT TO THE LOAN DOCUMENTS (AS NOW OR HEREAFTER MODIFIED) OR ANY OTHER INSTRUMENT, DOCUMENT OR AGREEMENT EXECUTED OR DELIVERED IN CONNECTION HEREWITH, OR THE TRANSACTIONS RELATED HERETO OR THERETO, IN EACH CASE WHETHER SUCH CLAIM, DEMAND, ACTION OR CAUSE OF ACTION IS NOW EXISTING OR HEREAFTER ARISING, AND WHETHER SOUNDING IN CONTRACT OR TORT OR OTHERWISE; AND EACH PARTY HEREBY AGREES AND CONSENTS THAT ANY PARTY TO THIS AGREEMENT MAY FILE AN ORIGINAL COUNTERPART OR A COPY OF THIS SECTION WITH ANY COURT AS WRITTEN EVIDENCE OF THE CONSENT OF THE PARTIES HERETO TO THE WAIVER OF ANY RIGHT THEY MIGHT OTHERWISE HAVE TO TRIAL BY JURY.

 

9.8 SEVERABILITY . If any provision or obligation under this Agreement and the other Loan Documents shall be determined by a court of competent jurisdiction to be invalid, illegal or unenforceable, that provision shall be deemed severed from the Loan Documents and the validity, legality and enforceability of the remaining provisions or obligations shall remain in full force as though the invalid, illegal, or unenforceable provision had never been a part of the Loan Documents, provided , however , that if the rate of interest or any other amount payable under the Note or this Agreement or any other Loan Document, or the right of collectability therefor, are declared to be or become invalid, illegal or unenforceable, Lender’s obligations to make any additional advances under the Loan Documents shall not be enforceable by Borrower.

 

9.9 HEIRS, SUCCESSORS AND ASSIGNS . Except as otherwise expressly provided under the terms and conditions of this Agreement, the terms of the Loan Documents shall bind and inure to the benefit of the heirs, successors and assigns of the Parties.

 

9.10 ATTORNEY IN FACT . Borrower hereby irrevocably appoints and authorizes Lender, as Borrower’s attorney in fact, which agency is coupled with an interest, to execute and/or record in Lender’s or Borrower’s name any notices, instruments or documents that Lender deems appropriate to protect Lender’s interest under any of the Loan Documents. The attorney in fact automatically terminates upon the release and reconveyance of the lien of the Deed of Trust.

 

9.11 TAX SERVICE . Lender is authorized, at Borrower’s expense, to obtain a tax service contract with a third party vendor which shall provide tax information on the Property satisfactory to Lender.

 

9.12 TIME . Time is of the essence of each and every term of this Agreement.

 

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9.13 GOVERNING LAW . This Agreement shall be governed by, and construed and enforced in accordance with the laws of the state of Texas, except to the extent preempted by federal laws. Borrower and all persons and entities in any manner obligated to Lender under the Loan Documents and Lender submit to the jurisdiction of: (a) any state or federal court sitting in the state of Texas over any suit, action, or proceeding, arising out of or relating to the Loan Documents or the Loan; (b) any state or federal court sitting in the state where the Property is located or the state in which a Party’s principal place of business is located over any suit, action or proceeding, arising out of or relating to any of the Loan Documents or the Loan; (c) any state court sitting in the county of the state where the Property is located over any suit, action, or proceeding brought by Lender to exercise its power to foreclose the Property or any action brought by Lender to enforce its rights with respect to any other collateral under the Loan Documents, and (d) consents to service of process by any means authorized by the law of the state where the Property is located or federal law. The Parties waive, to the fullest extent permitted by law, any objection that it may now or hereafter have to the laying of venue of any such suit, action, or proceeding brought in any such court and any claim that any such suit, action, or proceeding brought in any such court has been brought in an inconvenient forum.

 

9.14 INTEGRATION; INTERPRETATION; INCONSISTENCIES . The Loan Documents contain or expressly incorporate by reference the entire agreement of the Parties with respect to the matters contemplated therein and supersede all prior negotiations or agreements, written or oral. The Loan Documents shall not be modified except by written instrument executed by all Parties. Any reference to the Loan Documents includes any amendments, renewals or extensions now or hereafter approved by by the Parties in writing. In the event of any inconsistencies between the terms of this Agreement and the terms of any other Loan Document, the terms of this Agreement shall prevail.

 

9.15 JOINT AND SEVERAL LIABILITY . The liability of all persons and entities obligated in any manner under this Agreement and any of the Loan Documents shall be joint and several.

 

9.16 FORM OF DOCUMENTS . The form and substance of all documents, instruments, and forms of evidence to be delivered to Lender under the terms of this Agreement and any of the other Loan Documents shall be subject to Lender’s approval and shall not be modified, superseded or terminated in any respect without Lender’s prior written approval.

 

9.17 NO THIRD PARTIES BENEFITED. No person other than Lender and Borrower and their permitted successors and assigns shall have any right of action under any of the Loan Documents.

 

9.18 ACTIONS . Borrower agrees that Lender, in exercising the rights, duties or liabilities of Lender or Borrower under the Loan Documents, may commence, appear in or defend any action or proceeding purporting to affect the Property or the Loan Documents and Borrower shall immediately reimburse Lender upon demand for all such expenses so incurred or paid by Lender, including, without limitation, attorneys’ fees and expenses and court costs.

 

9.19 LENDER’S CONSENT . Wherever in this Agreement there is a requirement for Lender’s consent and/or a document to be provided or an action taken, it is understood that, except as expressly stated herein, Lender shall exercise its consent, right or judgment in a reasonable manner given the specific facts and circumstance applicable at the time.

 

9.20 HEADINGS . All article, section or other headings appearing in this Agreement and any of the other Loan Documents are for convenience of reference only and shall be disregarded in construing this Agreement and any of the other Loan Documents.

 

9.21 COUNTERPARTS . To facilitate execution, this document may be executed in as many counterparts as may be convenient or required. It shall not be necessary that the signature of, or on behalf of, each party, or that the signature of all persons required to bind any party, appear on each counterpart. All counterparts shall collectively constitute a single document. It shall not be necessary in making proof of this document to produce or account for more than a single counterpart containing the respective signatures of, or on behalf of; each of the parties hereto. Any signature page to any counterpart may be detached from such counterpart without impairing the legal effect of the signatures thereon and thereafter attached to another counterpart identical thereto except having attached to it additional signature pages.

 

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9.22 ARBITRATION .

 

  a. Arbitration . The Parties hereto agree, upon demand by any Party, to submit to binding arbitration all claims, disputes and controversies between or among them (and their respective employees, officers, directors, attorneys, and other agents), whether in tort, contract or otherwise arising out of or relating to in any way (i) the Loan and related Loan Documents which are the subject of this Agreement and its negotiation, execution, collateralization, administration, repayment, modification, extension, substitution, formation, inducement, enforcement, default or termination; or (ii) requests for additional credit.

 

  b. Governing Rules . Any arbitration proceeding will (i) proceed in a location in Texas selected by the American Arbitration Association (“ AAA ”); (ii) be governed by the Federal Arbitration Act (Title 9 of the United States Code), notwithstanding any conflicting choice of law provision in any of the documents between the Parties; and (iii) be conducted by the AAA, or such other administrator as the Parties shall mutually agree upon, in accordance with the AAA’s commercial dispute resolution procedures, unless the claim or counterclaim is at least $1,000,000.00 exclusive of claimed interest, arbitration fees and costs in which case the arbitration shall be conducted in accordance with the AAA’s optional procedures for large, complex commercial disputes (the commercial dispute resolution procedures or the optional procedures for large, complex commercial disputes to be referred to, as applicable, as the “ Rules ”). If there is any inconsistency between the terms hereof and the Rules, the terms and procedures set forth herein shall control. Any Party who fails or refuses to submit to arbitration following a demand by any other Party shall bear all costs and expenses incurred by such other party in compelling arbitration of any dispute. Nothing contained herein shall be deemed to be a waiver by any Party that is a bank of the protections afforded to it under 12 U.S.C. §91 or any similar applicable state law.

 

  c. No Waiver of Provisional Remedies, Self-Help and Foreclosure . The arbitration requirement does not limit the right of any Party to (i) foreclose against real or personal property collateral; (ii) exercise self-help remedies relating to collateral or proceeds of collateral such as setoff or repossession; or (iii) obtain provisional or ancillary remedies such as replevin, injunctive relief, attachment or the appointment of a receiver, before during or after the pendency of any arbitration proceeding. This exclusion does not constitute a waiver of the right or obligation of any Party to submit any dispute to arbitration or reference hereunder, including those arising from the exercise of the actions detailed in sections (i), (ii) and (iii) of this Section 9.22(c).

 

  d.

Arbitrator Qualifications and Powers . Any arbitration proceeding in which the amount in controversy is $5,000,000.00 or less will be decided by a single arbitrator selected according to the Rules, and who shall not render an award of greater than $5,000,000.00. Any dispute in which the amount in controversy exceeds $5,000,000.00 shall be decided by majority vote of a panel of three arbitrators; provided however, that all three arbitrators must actively participate in all hearings and deliberations. Any arbitrator(s) will be a neutral attorney licensed in the State of Texas or a neutral retired judge of the state or federal judiciary of Texas, in either case with a minimum of ten years of experience in the substantive law applicable to the subject matter of the dispute to be arbitrated. The arbitrator(s) will determine whether or not an issue is arbitratable and will give effect to the statutes of limitation in determining any claim. In any arbitration proceeding the arbitrator(s) will decide (by documents only or with a hearing at the arbitrator’s(s’) discretion) any pre-hearing motions which are similar to motions to dismiss for failure to state a claim or motions for summary adjudication. The arbitrator(s) shall resolve all disputes in accordance with the substantive law of Texas and may grant any remedy or relief that a court of such state could order or grant within the scope hereof and such ancillary relief as is necessary to make effective any award. The arbitrator(s) shall also have the power to award recovery of all costs and fees, to impose sanctions and to take such other action as the arbitrator(s) deems necessary to the same extent a judge could pursuant to the Federal Rules of Civil Procedure, the Texas Rules of Civil Procedure or other applicable law. Judgment upon the award rendered by the arbitrator(s) may be entered in any court having jurisdiction. The institution and maintenance of an action for judicial relief or pursuit of a provisional or ancillary remedy shall not constitute a waiver of the right of

 

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  any party, including the plaintiff, to submit the controversy or claim to arbitration if any other party contests such action for judicial relief. The Parties agree that the arbitrator’s decision is subject to review by the applicable courts to the greatest extent allowed by law.

 

  e. Discovery . In any arbitration proceeding discovery will be permitted in accordance with the Rules. All discovery shall be expressly limited to matters relevant to the dispute being arbitrated and must be completed no later than 20 days before the hearing date. Any requests for an extension of the discovery periods, or any discovery disputes, will be subject to final determination by the arbitrator(s) upon a showing that the request for discovery is essential for the Party’s presentation and that no alternative means for obtaining information is available.

 

  f. Class Proceedings and Consolidations . The resolution of any dispute arising pursuant to the terms of this Agreement shall be determined by a separate arbitration proceeding and such dispute shall not be consolidated with other disputes or included in any class proceeding.

 

  g. Payment of Arbitration Costs and Fees . The arbitrator(s) shall award all costs and expenses of the arbitration proceeding.

 

  h. Real Property Collateral; Judicial Reference . Notwithstanding anything herein to the contrary, no dispute shall be submitted to arbitration if the dispute concerns indebtedness secured directly or indirectly, in whole or in part, by any real property unless (i) the holder of the mortgage, lien or security interest specifically elects in writing to proceed with the arbitration, or (ii) all parties to the arbitration waive any rights or benefits that might accrue to them by virtue of the single action rule statute of Texas, thereby agreeing that all indebtedness and obligations of the Parties, and all mortgages, liens and security interests securing such indebtedness and obligations, shall remain fully valid and enforceable.

 

  i. Miscellaneous . To the maximum extent practicable, the AAA, the arbitrators and the Parties shall take all action required to conclude any arbitration proceeding within 180 days of the filing of the dispute with the AAA. No arbitrator or other Party to an arbitration proceeding may disclose the existence, content or results thereof, except for disclosures of information by a Party required in the ordinary course of its business or by applicable law or regulation, or to the extent necessary to exercise any judicial review rights set forth herein. If more than one agreement for arbitration by or between the Parties potentially applies to a dispute, the arbitration provision most directly related to the documents between the Parties or the subject matter of the dispute shall control. This arbitration provision shall survive termination, amendment or expiration of any of the documents or any relationship between the Parties.

 

9.23 EXHIBITS INCORPORATED. Exhibit A and B attached hereto, are hereby incorporated into this Agreement by this reference.

 

9.24 NO NOVATION; AMENDMENT AND RESTATEMENT . This Agreement is not intended to and shall not constitute a novation, payment and reborrowing or termination of the indebtedness or any other obligations under the Prior Loan Agreement. All loans made and obligations incurred under the Prior Loan Agreement which are outstanding on the Effective Date shall continue as loans and obligations under (and shall be governed by the terms of) this Agreement and the other Loan Documents. Upon this Agreement becoming effective pursuant to Section 2.1 on the Effective Date, (a) all terms and conditions of the Prior Loan Agreement and any other Loan Documents executed and delivered pursuant thereto, as amended by this Agreement and the other Loan Documents being executed and delivered in connection herewith, shall be and remain in full force and effect, as so amended; and (b) the terms and conditions of the Prior Loan Agreement shall be amended as set forth herein and, as so amended, the Prior Loan Agreement shall be restated in its entirety.

 

9.25

ACKNOWLEDGEMENT AND CONSENT BY GUARANTORS . Each of the Guarantors hereby acknowledges that it has read this Agreement and the other Loan Documents being executed and delivered in connection herewith and consents to the terms hereof and thereof, and hereby confirms, acknowledges and

 

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  agrees that (i) the Loan and the Note as defined in this Agreement constitute the “Loan” and the “Note” under the Loan Documents to which such Grantor is a party and (ii) notwithstanding the effectiveness of this Amendment, the obligations of such Guarantor under the Loan Documents to which such Guarantor is a party shall not be impaired or affected and the Loan Documents to which such Guarantor is a party are, and shall continue to be, in full force and effect and are hereby confirmed and ratified in all respects. Each of the Guarantors further agrees that nothing in this Agreement or any other Loan Document shall be deemed to require the consent of such Guarantor to any future amendment to this Agreement.

[Remainder of Page Intentionally Left Blank.]

 

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IN WITNESS WHEREOF, Borrower and Lender have executed this Agreement as of the date first written above.

LENDER:

WELLS FARGO BANK,

NATIONAL ASSOCIATION

 

By:  

/s/ Alan Prohaska

Name:   Alan Prohaska
Title:   Vice President

Lender’s Address :

WELLS FARGO BANK, NATIONAL ASSOCIATION

Carlsbad Regional Commercial Banking Office

5901 Priestly Drive, Suite 130

Carlsbad, CA 92008

Attention: Alan Prohaska and Samantha Jones

 

Amended and Restated Loan Agreement


BORROWER:

GREENHOUSE REAL ESTATE, LLC,

a Texas limited liability company

By:  

/s/ Michael T. Cartwright

Name:   Michael T. Cartwright
Title:   Sole Manager and Chairman

Borrower’s Address :

115 East Park Drive, Second Floor

Brentwood, TN 37027

 

Amended and Restated Loan Agreement


Acknowledged and Agreed to :

GUARANTORS:

AMERICAN ADDICTION CENTERS, INC.

 

By:  

/s/ Michael T. Cartwright

Name:   Michael T. Cartwright
Title:   Chairman & CEO
BEHAVIORAL HEALTHCARE REALTY, LLC
By:  

/s/ Michael T. Cartwright

Name:   Michael T. Cartwright
Title:   Manager

/s/ Michael T. Cartwright

Michael T. Cartwright, an individual

/s/ Jerrod Menz

Jerrod Menz, an individual

 

Amended and Restated Loan Agreement


EXHIBIT A

DESCRIPTION OF PROPERTY

Exhibit A to AMENDED AND RESTATED LOAN AGREEMENT between GREENHOUSE REAL ESTATE, LLC, a Texas limited liability company, as “ Borrower ”. and WELLS FARGO BANK, NATIONAL ASSOCIATION, as “ Lender ”.

All that certain real property located in the County of Tarrant, State of Texas, described as follows:

Being a lot, tract or parcel of land situated in the J. Goodwin Survey, Abstract No. 595, and J.R. Parker Survey, Abstract No. 1227, City of Grand Prairie, Tarrant County, Texas, and being all of Revised Site 2, Blocks 1 and 13, Industrial Community No. 1, Great Southwest Industrial District, an addition to the City of Grand Prairie, Tarrant County, Texas, as recorded in Volume 388-29, Page 47, Plat Records, Tarrant County, Texas, and a portion of Revised Site 1, Blocks 1 and 13, Industrial Community No. 1, Great Southwest Industrial District, an addition to the City of Arlington, Tarrant County, Texas, as recorded in Volume 388-27, Page 457, Plat Records, Tarrant County, Texas, and being more particularly described as follows:

Commencing at the intersection of the North line of Avenue “H” East (80’ R.O.W.) and the West line of 107th Street (100’ R.O.W.); Thence North along the West line of said 107th Street for a distance of 827.31 feet to the Point of Beginning, said point being the most Easterly Northeast corner of a 19.368 acre tract of land as recorded in Volume 388-139, Page 37, Plat Records, Tarrant County, Texas;

Thence West along the North line of said 19.368 acre tract, a distance of 355.00 feet to a 1/2 inch iron rod found for corner;

Thence North, along an interior East line of said 19.368 acre tract, a distance of 52.00 feet to a 1/2 inch iron rod found for corner;

Thence South 89 degrees 59 minutes 32 seconds West, a distance of 104.22 feet to a 1/2 inch iron rod found for corner in the North line of Site 7, Block 13;

Thence South 89 degrees 22 minutes 41 seconds West, along the North line of Site 7, Block 13, a distance of 17.70 feet to a 1/2 inch iron rod found for corner;

Thence North 01 degrees 03 minutes 28 seconds East along the North line of Site 7, Block 13, a distance of 8.23 feet to a 1/2 inch iron rod found for corner;

Thence North 12 degrees 38 minutes 28 seconds West, a distance of 249.65 feet to a 1/2 inch iron rod for corner and the beginning of a curve to the left, having a radius of 294.12 feet, a central angle of 41 degrees 51 minutes 09 seconds, a chord bearing of North 33 degrees 26 minutes 11 seconds West, a chord distance of 210.10;

Thence long said curve to the left, an arc length of 214.84 feet to a 1/2 inch iron rod found for corner in the South line of Arlington Golf Club, Inc.;

Thence South 89 degrees 48 minutes 26 seconds East, along the South line of Arlington Golf Club, Inc., a distance of 187.67 feet to a 1/2 inch iron rod found for corner and being the Northwest corner of Site 2, Block 1 and 13, Industrial Community No. 1, Great Southwest Industrial District;

Thence East, along the North line of said Site 2, Block 1 and 13, Industrial Community No. 1, Great Southwest Industrial District, a distance of 473.38 feet to a 1/2 inch iron rod found for corner in the West line of said 107th Street and the intersection of a curve to the left, having a radius of 1158.84 feet, a central angle of 06 degrees 23 minutes 06 seconds, a chord bearing of South 07 degrees 42 minutes 13 seconds West, a chord distance of 129.08 feet;

 


Thence along said curve to the left, an arc length of 129.14 feet to a 1/2 inch iron rod found for corner and the point of compound curvature to the left, having a radius of 1226.46 feet, a central angle of 08 degrees 54 minutes 18 seconds, a chord bearing of South 00 degrees 03 minutes 31 seconds West, a chord distance of 190.43 feet;

Thence along said curve to the left, an arc length of 190.62 feet to a 1/2 inch iron rod found for corner and the point of reverse curvature to the right, having a radius of 1226.46 feet, a central angle of 04 degrees 23 minutes 38 seconds, a chord bearing of South 02 degrees 11 minutes 49 seconds East, a chord distance of 94.03 feet;

Thence along said curve to the right, an arc length of 94.05 feet to a 1/2 inch iron rod found for corner;

Thence South, continuing along said West R.O.W. line of 107th Street, a distance of 66.02 feet to the Point of Beginning and containing 244,577.87 square feet or 5.615 acres of land, more or less.

Address: 1171 107 th Street, Grand Prairie, Tarrant County, Texas

 

Amended and Restated Loan Agreement


EXHIBIT B

DOCUMENTS

Exhibit B to AMENDED AND RESTATED LOAN AGREEMENT between GREENHOUSE REAL ESTATE. LLC, a Texas limited liability company, as “Borrower”. and WELLS FARGO BANK, NATIONAL ASSOCIATION, as “Lender” (“ Agreement ”).

 

1. LOAN DOCUMENTS . The documents listed below and amendments, modifications and supplements thereto which have received the prior written consent of Lender, together with any documents executed in the future that are approved by Lender and that recite that they are “Loan Documents” for purposes of this Agreement are collectively referred to herein as the Loan Documents.

 

  1.1 This Agreement.

 

  1.2 Note.

 

  1.3 Uniform Commercial Code National Financing Statement Form UCC-1.

 

  1.4 Amended and Restated Deed of Trust, Assignment of Rent and Leases, Security Agreement and Fixture Filing, dated as of the Effective Date, which amended and restated the Construction Deed of Trust with Absolute Assignment of Leases and Rents, Security Agreement and Fixture Filing, dated as of October 8, 2013 and recorded under Instrument # D213269290 in Tarrant County, Texas.

 

  1.4 Repayment Guaranty, dated as of October 8, 2013, by MICHAEL CARTWRIGHT, an individual (“ Cartwright ”), JERROD MENZ, an individual (“ Menz ”), AMERICAN ADDICTION CENTERS, INC., a Nevada corporation (“ AAC ”), and BEHAVIORAL HEALTHCARE REALTY, LLC, a Delaware limited liability company (“ BHR ” and, together with Cartwright, Menz and AAC collectively, “ Guarantors ”), in favor of Lender, as amended by the Amendment and Joinder to Repayment guaranty, Completion guaranty and Hazardous Materials Indemnity Agreement, dated as of April 15, 2014 (the “ Amendment and Joinder ”).

 

  1.5 Completion Guaranty, dated as of October 8, 2013, by the Guarantors in favor of Lender, as amended by the Amendment and Joinder.

 

  1.6 Hazardous Materials Indemnity Agreement, dated as of October 8, 2013, by the Guarantors in favor of Lender, as amended by the Amendment and Joinder.

 

  1.7 Amended and Restated Subordination Agreement; Acknowledgment of Lease Assignment, Estoppel and Attornment Agreement, dated as of the Effective Date, which amended and restated the Subordination Agreement; Acknowledgment of Lease Assignment, Estoppel and Attornment Agreement, dated as of October 8, 2013 and recorded under Instrument # D213269291 in Tarrant County, Texas.

 

  1.8 Assignment of Construction Agreements, dated as of October 8, 2013, executed by Borrower in favor of Lender and consented to by the contractor named therein.

 

  1.9 Assignment of Architectural Agreements and Plans and Specifications, dated as of October 8, 2013, executed by Borrower in favor of Lender and consented to by the architect named therein.


2. OTHER RELATED DOCUMENTS (WHICH ARE NOT LOAN DOCUMENTS)

 

  2.1 Limited Liability Company Borrowing Certificate executed by Borrower.
  2.2 Corporate Resolution Continuing Guaranty certified by the Secretary of AAC.

 

  2.3 Limited Liability Company Certificate Continuing Guaranty executed by BHR.

 

  2.4 Agreement for Disbursement Prior to Recording and Amendment to Note executed by Borrower and Lender.

Exhibit 10.47

REAL ESTATE TERM NOTE

 

$12,740,000.00   Carlsbad, California
  August 13, 2014

FOR VALUE RECEIVED, the undersigned GREENHOUSE REAL ESTATE, LLC (“ Borrower ”) promises to pay to the order of WELLS FARGO BANK, NATIONAL ASSOCIATION (“ Lender ”) at its office at 5901 Priestly Drive, Suite 130, Carlsbad, California 92008, or at such other place as the holder hereof may designate, in lawful money of the United States of America and in immediately available funds, the principal sum of TWELVE MILLION SEVEN HUNDRED FORTY THOUSAND AND NO/100THS DOLLARS ($12,740,000.00), with interest thereon as set forth herein.

This Note is made pursuant to and is subject to the terms and conditions of that certain Amended and Restated Loan Agreement, dated as of the date hereof (as amended, restated, supplemented or otherwise modified from time to time, the “ Loan Agreement ”), between Borrower and Lender. Capitalized terms used herein without definition shall have the meanings assigned to such terms in the Loan Agreement.

DEFINITIONS:

As used herein, the following terms shall have the meanings set forth after each, and any other term defined in this Note shall have the meaning set forth at the place defined:

(a) “Business Day” means any day except a Saturday, Sunday or any other day on which commercial banks in the jurisdiction described in “Governing Law” herein are authorized or required by law to close.

(b) “LIBOR” means the rate of interest per annum determined by Lender based on the rate for United States dollar deposits for delivery on the first day of each LIBOR Period for a period approximately equal to such LIBOR Period as reported on Reuters Screen LIBOR01 page (or any


successor page) at approximately 11:00 a.m., London time, two London Business Days prior to the first day of such LIBOR Period (or if not so reported, then as determined by Lender from another recognized source or interbank quotation).

(c) “LIBOR Period” means a period of one (1) month during which the entire outstanding principal balance of this Note bears interest determined in relation to LIBOR, with the understanding that: (i) the initial LIBOR Period shall commence on the Effective Date and shall continue up to, but shall not include, September 15, 2014, subject to the provisions of (iii) below; (ii) thereafter, each LIBOR Period shall commence automatically, without notice to or consent from Borrower, on the 15 th day of each month and shall continue up to, but shall not include, the 15 th day of the immediately following month; (iii) if any LIBOR Period is scheduled to commence on a day that is not a London Business Day, then such LIBOR Period shall commence on the next succeeding London Business Day (and the preceding LIBOR Period shall continue up to, but shall not include, the first day of such LIBOR Period), unless the result of such extension would be to cause such LIBOR Period to begin in the next calendar month, in which event such LIBOR Period shall commence on the immediately preceding London Business Day (and the preceding LIBOR Period shall continue up to, but shall not include, the first day of such LIBOR Period); and (iv) if, on the first day of the last LIBOR Period applicable hereto the remaining term of this Note is less than one (1) month, said LIBOR Period shall be in effect only until the scheduled maturity date hereof.

(d) “London Business Day” means any day that is a day for trading by and between banks in Dollar deposits in the London interbank market.

(e) “New York Business Day” means any day except a Saturday, Sunday or any other day on which commercial banks in New York are authorized or required by law to close.

(f) “Prime Rate” means at any time the rate of interest most recently announced within Lender at its principal office as its Prime Rate, with the understanding that the Prime Rate is one of Lender’s base rates and serves as the basis upon which effective rates of interest are calculated for those loans making reference thereto, and is evidenced by the recording thereof after its announcement in such internal publication or publications as Lender may designate.

 

2


INTEREST:

(a) Interest . The outstanding principal balance of this Note shall bear interest (computed on the basis of a 360-day year, actual days elapsed at a fixed rate per annum determined by Lender to be two and a half percent (2.50%) above LIBOR in effect on the first day of each LIBOR Period. With respect to each LIBOR Period hereunder, Lender is hereby authorized to note the date and interest rate applicable thereto and any payments made thereon on Lender’s books and records (either manually or by electronic entry) and/or on any schedule attached to this Note, which notations shall be prima facie evidence of the accuracy of the information noted. Borrower shall reimburse Lender immediately upon demand for any loss or expense (including any loss or expense incurred by reason of the liquidation or redeployment of funds obtained to fund or maintain a LIBOR borrowing) incurred by Lender as a result of the failure of Borrower to accept or complete a LIBOR borrowing hereunder after making a request therefor. Any reasonable determination of such amounts by Lender shall be conclusive and binding upon Borrower.

(b) Taxes and Regulatory Costs . Borrower shall pay to Lender immediately upon demand, in addition to any other amounts due or to become due hereunder, any and all (i) withholdings, interest equalization taxes, stamp taxes or other taxes (except income and franchise taxes) imposed by any domestic or foreign governmental authority and related in any manner to LIBOR, and (ii) costs, expenses and liabilities arising from or in connection with reserve percentages prescribed by the Board of Governors of the Federal Reserve System (or any successor) for “Eurocurrency Liabilities” (as defined in Regulation D of the Federal Reserve Board, as amended), assessment rates imposed by the Federal Deposit Insurance Corporation, or similar requirements or costs imposed by any domestic or foreign governmental authority or resulting from compliance by Lender with any request or directive (whether or not having the force of law) from any central Lender or other governmental authority and related in any manner to LIBOR. In determining which of the foregoing are attributable to any LIBOR option available to Borrower hereunder, any reasonable allocation made by Lender among its operations shall be conclusive and binding upon Borrower.

(c) Payment of Interest . Interest accrued on this Note shall be payable on the fifteenth day of each month (or, if such day is not a Business Day, on the next Business Day), commencing September 15, 2014.

(d) Default Interest . From and after the maturity date of this Note, or such earlier date as all principal owing hereunder becomes due and payable by acceleration or otherwise, or at Lender’s option upon the occurrence, and during the continuance of any Default, the outstanding principal balance of this Note shall bear interest at an increased rate per annum (computed on the basis of a 360-day year, actual days elapsed) equal to five percent (5%) above the rate of interest from time to time applicable to this Note.

 

3


REPAYMENT:

(a) Repayment . Principal shall be payable on the fifteenth (15th) day of each month (or, if such day is not a Business Day, on the next Business Day) in installments of Seventy Thousand Seven Hundred Seventy Seven Dollars and 78/100 ($70,777.78) each, commencing September 15, 2014, and continuing up to and including July 15, 2019, with a final installment consisting of all remaining unpaid principal due and payable in full on August 13, 2019 (the “ Maturity Date ”).

(b) Application of Payments . Each payment made on this Note shall be credited first, to any interest then due and second, to the outstanding principal balance hereof.

(c) Collection of Payments . Borrower authorizes Lender to collect all principal, interest, fees and other charges due under this Note by charging Borrower’s deposit account number 3015212 with Lender, or any other deposit account maintained by Borrower with Lender, for the full amount thereof. Should there be insufficient funds in any such deposit account to pay all such sums when due, the full amount of such deficiency shall be immediately due and payable by Borrower.

(d) Late Charge . If any payment required hereunder is not paid within ten (10) days following the date it becomes due, Borrower shall pay a late charge equal to five percent (5%) of the amount of such unpaid payment.

PREPAYMENT:

(a) Prepayment . Borrower may prepay principal on this Note in the minimum amount of One Hundred Thousand Dollars ($100,000.00); provided however, that if the outstanding principal balance of this Note is less than said amount, the minimum prepayment amount shall be the entire outstanding principal balance hereof. In consideration of Lender providing this prepayment option to Borrower, or if this Note shall become due and payable at any time prior to the last day of any LIBOR Period by acceleration or otherwise, Borrower shall pay to Lender immediately upon demand a fee which is the sum of the discounted monthly differences for each month from the month of prepayment through the month in which such LIBOR Period matures, calculated as follows for each such month:

 

  (i) Determine the amount of interest which would have accrued each month on the amount prepaid at the interest rate applicable to such amount had it remained outstanding until the last day of the LIBOR Period applicable thereto.

 

4


  (ii) Subtract from the amount determined in (i) above the amount of interest which would have accrued for the same month on the amount prepaid for the remaining term of such LIBOR Period at LIBOR in effect on the date of prepayment for new loans made for such term and in a principal amount equal to the amount prepaid.

 

  (iii) If the result obtained in (ii) for any month is greater than zero, discount that difference by LIBOR used in (ii) above.

Borrower acknowledges that prepayment of such amount may result in Lender incurring additional costs, expenses and/or liabilities, and that it is difficult to ascertain the full extent of such costs, expenses and/or liabilities. Borrower, therefore, agrees to pay the above-described prepayment fee and agrees that said amount represents a reasonable estimate of the prepayment costs, expenses and/or liabilities of Lender. If Borrower fails to pay any prepayment fee when due, the amount of such prepayment fee shall thereafter bear interest until paid at a rate per annum two percent (2.00%) above the Prime Rate in effect from time to time (computed on the basis of a 360-day year, actual days elapsed).

(b) Application of Prepayments . All prepayments of principal shall be applied on the most remote principal installment or installments then unpaid.

 

5


EVENTS OF DEFAULT:

Any Default under the Loan Agreement shall constitute a Default under this Note.

MISCELLANEOUS:

(a) Remedies . Upon the sale, transfer, hypothecation, assignment or other encumbrance, whether voluntary, involuntary or by operation of law, of all or any interest in any real property securing this Note, or upon the occurrence of any Default, the holder of this Note, at the holder’s option, may declare all sums of principal and interest outstanding hereunder to be immediately due and payable without presentment, demand, notice of nonperformance, notice of protest, protest or notice of dishonor, all of which are expressly waived by Borrower. Borrower shall pay to the holder immediately upon demand the full amount of all payments, advances, charges, costs and expenses, including reasonable attorneys’ fees (to include outside counsel fees), expended or incurred by the holder in connection with the enforcement of the holder’s rights and/or the collection of any amounts which become due to the holder under this Note, and the prosecution or defense of any action in any way related to this Note, including without limitation, any action for declaratory relief, whether incurred at the trial or appellate level, in an arbitration proceeding or otherwise, and including any of the foregoing incurred in connection with any bankruptcy proceeding (including without limitation, any adversary proceeding, contested matter or motion brought by Lender or any other person) relating to Borrower or any other person or entity.

(b) Assignment . Lender reserves the right to sell, assign, transfer, negotiate or grant participations in all or any part of, or any interest in, Lender’s rights and benefits under this Note.

(c) Governing Law . This Note shall be governed by and construed in accordance with the laws of the State of Texas.

(d) Arbitration . All claims, disputes and controversies between the parties hereto shall be submitted to binding arbitration pursuant to the terms of the Loan Agreement.

 

6


(e) Amendment and Restatement . This Note amends and restates in its entirety the Promissory Note Secured By Deed of Trust, dated as of October 8, 2013, issued by Borrower to Lender (as amended or otherwise modified to the date hereof, the “ Prior Note ”). Each of the Borrower and Lender acknowledges and agrees that this Note does not constitute a novation, payment and reborrowing or termination of the obligations under the Prior Note and that all such obligations are in all respects continued and outstanding as obligations under this Note.

[Remainder of Page Intentionally Left Blank.]

 

7


IN WITNESS WHEREOF, the undersigned has executed this Note as of the date first written above.

 

GREENHOUSE REAL ESTATE, LLC
By:  

/s/ Michael T. Cartwright

Name:   Michael T. Cartwright
Title:   Sole Manager and Chairman

 

 

Greenhouse Real Estate, LLC Note

Exhibit 21.1

LIST OF SUBSIDIARIES

 

Name of Subsidiary

  

Jurisdiction of Incorporation or Organization

(Including d/b/a name, if applicable)     

American Addiction Centers, Inc.

   Nevada

AAC Dallas Outpatient Center, LLC

   Delaware

AAC Las Vegas Outpatient Center, LLC

   Delaware

Addiction Labs of America, LLC

   Delaware

ABTTC, Inc.

   California

B&B Holdings Intl LLC

   Florida

Hamilton Medically Assisted Treatment Associates, LLC

   New Jersey

Leading Edge Recovery Center, LLC

   New Jersey

Singer Island Recovery Center LLC d/b/a The Academy

   Florida

The Heights Supportive Housing, LLC

   New Jersey

Concorde Treatment Center, LLC d/b/a Desert Hope Center

   Nevada

FitRx, LLC

   Tennessee

Forterus Health Care Services, Inc.

   Delaware

Greenhouse Treatment Center, LLC

   Texas

Parallax Center, LLC

   Delaware

San Diego Addiction Treatment Center, Inc.

   Delaware

Behavioral Healthcare Realty, LLC

   Delaware

Concorde Real Estate, LLC

   Nevada

Greenhouse Real Estate, LLC

   Texas

The Academy Real Estate, LLC

   Delaware

Clinical Revenue Management Services, LLC

   Tennessee

Exhibit 23.1

Consent of Independent Registered Public Accounting Firm

AAC Holdings, Inc.

Nashville, Tennessee

We hereby consent to the use in the Prospectus constituting a part of this Registration Statement on Form S-1 of our report dated May 2, 2014, relating to the consolidated financial statements of American Addiction Centers, Inc. and Subsidiaries; our report dated June 20, 2013, relating to the combined financial statements of AJG Solutions, Inc. and B&B Holdings Intl LLC; and our report dated April 24, 2014, relating to the Historical Statements of Revenues and Certain Direct Operating Expenses of Greenhouse Real Estate, LLC, all of which are contained in that Prospectus.

We also consent to the reference to us under the caption “Experts” in the Prospectus.

/s/ BDO USA, LLP

Nashville, Tennessee

August 15, 2014